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目的研究三七总皂苷与卡维地洛对心肌梗死后大鼠左室心功能改善作用的疗效并比较评价。方法手术法结扎左冠状动脉前降支建立SD大鼠AMI模型36只,将模型鼠随机分为心梗对照组(AMI组),三七总皂苷治疗组(PNS组,80 mg·kg~(-1)·d~(-1))和卡维地洛治疗组(CARV组,6 mg·kg~(-1)·d~(-1)),每组12只;另设假结扎组(Sh组,12只)。术后24小时开始灌胃给药,4周后对各组大鼠进行超声心动图心功能和血浆脑钠肽(NT-proBNP)浓度检测。结果 (1)与Sh组比较,AMI组左室射血分数(EF)和左室收缩百分率(FS)、室间隔舒张、收缩末期厚度(IVSd、IVSs)与左室前壁收缩末期厚度(LVAWDs)均明显降低(P<0.01),左室舒张、收缩末期内径(LVIDd、LVIDs)显著增加,且左室后壁收缩末期厚度(LVPWDs)明显增加(P<0.05)。而二尖瓣血流E/A比值下降明显;心肌运动应变率(Radial Strain Rate)减小,达峰时间(TPK,ms)明显延长;NT-proBNP浓度显著增高(P<0.01)。(2)与AMI组比较,PNS组和CARV组的EF、FS、IVSd、IVSs与LVAWDs明显增加,而LVIDd、LVIDs和LVPWDs明显降低(P<0.01);且心肌运动应变率明显增加,达峰时间明显缩短;NT-proBNP浓度明显降低。(3)PNS组与CARV组比较,PNS组的EF、FS和LVAWDs增加显著,LVIDd、LVIDs减小明显;而IVSd、IVSs、和LVPWDs无明显差异(P>0.05)。并且,PNS组的二尖瓣血流E峰、A峰和E峰下降速率均明显增大(P<0.05),而E/A比值和心肌应变率、达峰时间与NTproBNP浓度两组无明显差异。结论心肌梗死后大鼠的左心室收缩和舒张功能异常严重;用三七总皂苷和卡维地洛治疗4周后均能明显改善其心功能,防止心衰;但PNS在提高EF、LVAWDs和二尖瓣血流方面更优于卡维地洛。
Objective To study the effect of Panax notoginseng saponins and carvedilol on the improvement of left ventricular function after myocardial infarction in rats. Methods Thirty-six AMI models of SD rats were established by ligating left anterior descending coronary artery. The model rats were randomly divided into AMI group, PNS group (80 mg · kg ~ (-1) (-1) · d ~ (-1)) and carvedilol treatment group (CARV group, 6 mg · kg -1 · d -1) (Sh group, 12 rats). Gavage administration started 24 hours after operation, and echocardiographic cardiac function and plasma brain natriuretic peptide (NT-proBNP) concentrations were measured 4 weeks later. Results Compared with Sh group, left ventricular ejection fraction (EF), left ventricular ejection fraction (FS), interventricular septum diastole, end-systolic thickness (IVSd, IVSs) and left ventricular anterior systolic thickness (LVAWDs) ) Were significantly decreased (P <0.01). Left ventricular diastolic and end-diastolic dimension (LVIDs) were significantly increased, while left ventricular posterior wall thickness (LVPWDs) were significantly increased (P <0.05). While the E / A ratio of mitral valve blood flow decreased significantly. The myocardial Strain Rate decreased, the peak time (TPK, ms) prolonged significantly, and NT-proBNP concentration increased significantly (P <0.01). (2) Compared with AMI group, the EF, FS, IVSd, IVSs and LVAWDs in PNS group and CARV group were significantly increased, but LVIDd, LVIDs and LVPWDs were significantly decreased (P <0.01); the myocardial strain rate was increased Time significantly reduced; NT-proBNP concentration was significantly reduced. (3) Compared with CARV group, the PNS group had significant increase of EF, FS and LVAWDs, LVIDd and LVIDs decreased obviously, but there was no significant difference between IVSd, IVSs and LVPWDs (P> 0.05). Moreover, the mitral flow E, peak A and peak E velocities in PNS group were significantly increased (P <0.05), while E / A ratio and myocardial strain rate, peak time and NTproBNP concentration had no significant difference difference. Conclusions The left ventricular systolic and diastolic function of rats after myocardial infarction was abnormal. After treated with notoginseng total saponin and carvedilol for 4 weeks, their cardiac function and heart failure could be improved obviously. However, PNS increased EF, LVAWDs and mitral edema Valvular flow is better than carvedilol.