摘要
目的探讨醛固酮拮抗剂螺内酯(spironolactone)对实验性高血压大鼠心脏结构和功能的干预作用,以及对血浆肾上腺髓质素(adrenomedullin,ADM)的影响。方法腹主动脉缩窄法建立高血压动物模型,44只雄性Wistar大鼠随机分为高血压模型组、培哚普利(derindopril)[2 mg/(kg.d)]组、螺内酯[20 mg/(kg.d)]组和假手术对照组。治疗12周后,各组分别应用超声检测心脏结构和功能,放射免疫法检测血浆ADM水平。结果心脏超声结果显示,螺内酯组和培哚普利组同高血压模型组比较,舒张末期室间隔厚度、左室后壁厚度、相对室壁厚度、左室质量、左室内径及左房内径明显下降,且均有统计学意义(P<0.01,P<0.05);同培哚普利组比较,螺内酯组相对室壁厚度明显下降,有统计学意义(P<0.01)。螺内酯组、培哚普利组同高血压模型组比较血浆ADM水平明显下降,有统计学意义(P<0.01)。结论螺内酯和培哚普利均能逆转左室肥厚,改善心脏舒张功能,且螺内酯逆转左室肥厚优于培哚普利;应用螺内酯和培哚普利后,血浆ADM水平下降,伴随左室肥厚和舒张功能的改善,其机制可能为ADM在高血压中作为代偿性激素,可与肾素-血管紧张素-醛固酮系统(renin angiotensin aldosteronesystem,RAAS)相互拮抗,或通过ADM直接作用,逆转左室肥厚。
Objective To investigate the effects of spironolactone on cardiac structure and function, and the concentration of plasma adrenomedullin in hypetrensive rats. Methods The model of hypertensive rat was established by abdominal aortic constriction. Fouty-four male Wistar rats were randomly divided into four groups： hypertension group （hypertensive rats serving as controls）, derindopril group （hypertensive rats subjected to derindopril treatment, 2 mg/（kg·d）, spironolactone group （hypertensive rats receiving spironolactone treatment, 20 mg/（kg ·d）, control group （sham operated rats serving as controls）, each group has 11 rats. After treatment of 12 weeks, cardiac structure and function were detected in all groups by ultrosonography, and then plasma adrenomedullin were examined by radioimmunity. Results Compared with hypertension group, interventricular septal thickness （IVSTd）, left ventricular posterior wall thickness （LVPWTd）, relative wall thickness （RWT） of left vertricular, left ventricular mass （LVM）, left ventrieular end-diastolic diameter （LVEDD）, left atrial diameter （LAD） in spironolactone group and derindopril group decreased significantly （ P〈0.01, P〈0.05）. Spironolactone group decreased more than derindopril group in RWT（P 〈0.01）. Compared with hypertension group both spironolactone and derindopril attenuated the increases of plasma ADM （ P 〈0.01）. Conclusion Both spironolaetone and derindopril attenuate the increase of left ventricular hypertrophy and improve left ventricular diastolic function. Spironlaetone is much more effective than derindopril in preventing left ventrieular hypertrophy. After treament of spironolactone and derindopril plasma ADM decreased, companying the improvement of left ventricular hypertrophy and diastolic function, the mechanism may be that plasma ADM played a compensatory role through inhibition renin angiotensin aldosterone system and （or） a direct effect.
出处
《河北医科大学学报》
CAS
2005年第5期343-346,共4页
Journal of Hebei Medical University
基金
河北省科技厅科研基金(002061124D)
关键词
高血压
肥大
左心室
螺内酯
肾上腺髓质
大鼠
hypertension
hypertrophy, left ventrieular
spironolaetone
adrenomedullin
rats
