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目的:探讨滋阴潜阳活血汤对肾性高血压大鼠左室肥厚的影响及作用机制。方法:建立2K1C肾性高血压大鼠模型,随机分为模型组、中药组及假手术对照组。假手术组和模型组:生理盐水80mg.kg-1.d-1,腹腔注射,连续8周;中药组:滋阴潜阳活血汤剂浓缩后40g.kg-1.d-1,连续灌胃给药8周。8周后,分别测定各组大鼠平均颈动脉压(mCAP)、左室舒张末期压(LVEDP)以及左心室压力变化最大速率(LV±dp/dtmax)、左心重与体重比值(LVMI=LVM/BW),放射免疫法测定血浆及局部心肌血管紧张素Ⅱ(AngⅡ),透射电镜观察心肌形态学的变化。结果:①与假手术组相比,模型组大鼠mCAP、LVEDP和LVMI均明显升高(P<0.01),LV+dp/dtmax降低(P<0.05),血浆及心肌AngⅡ显著升高(P<0.01),左室肥厚形成,左室重构发生,心功能下降。②与模型组相比,中药组LV+dp/dtmax和LV-dp/dtmax则明显升高(P<0.01或P<0.05),而mCAP、LVEDP和LVMI则显著降低(P<0.01或P<0.05),血浆及心肌AngⅡ亦显著降低(P<0.01),表明中药组能够降低血压并逆转左室肥厚。③电镜观察:模型组大鼠心室肌丝松散,部分溶解断裂,闰盘增宽;基膜下轻度水肿。与模型组比较,中药组上述病变明显减轻。假手术组未见上述病变。结论:滋阴潜阳活血汤能有效地降低肾性高血压大鼠血压并逆转左室肥厚,其作用机制可能与降低血浆及心肌局部AngⅡ、抑制体内肾素-血管紧张素系统(RAS)代谢有关。
Objective: To investigate the effect and mechanism of ziyin qiyanghuoxue decoction on left ventricular hypertrophy in renovascular hypertensive rats. Methods: The model of 2K1C renal hypertension was established and randomly divided into model group, TCM group and sham operation control group. Sham operation group and model group: saline 80mg.kg-1.d-1, intraperitoneal injection for 8 weeks; Chinese medicine group: Ziyinqianyanghuoxue Decoction concentration 40g.kg-1.d-1, continuous irrigation Stomach administration for 8 weeks. After 8 weeks, mean carotid blood pressure (mCAP), left ventricular end-diastolic pressure (LVEDP), left ventricular pressure maximum rate (LV ± dp / dtmax), left ventricular weight to body weight ratio / BW). Plasma and regional myocardial angiotensin Ⅱ (AngⅡ) were measured by radioimmunoassay. The morphological changes of myocardium were observed by transmission electron microscopy. Results: ① Compared with the sham operation group, mCAP, LVEDP and LVMI in model group were significantly increased (P <0.01), LV + dp / dtmax was decreased (P <0.05) <0.01), left ventricular hypertrophy, left ventricular remodeling, decreased cardiac function. ②Compared with model group, LV + dp / dtmax and LV-dp / dtmax of TCM group were significantly increased (P <0.01 or P <0.05), while mCAP, LVEDP and LVMI were significantly decreased (P <0.01 or P < 0.05), and plasma AngⅡ levels were also significantly decreased (P <0.01), indicating that the Chinese medicine group can reduce blood pressure and reverse left ventricular hypertrophy. Electron microscope observation: The ventricular myocytes in the model group were loose and partly dissolved and broken, and the intercalated disc broadened; mild edema was found in the basilar membrane. Compared with the model group, the TCM group significantly reduced the above lesions. Sham-operated group did not see the above lesions. Conclusion: Ziyinqianyanghuoxue Decoction can effectively decrease blood pressure and reverse left ventricular hypertrophy in rats with renal hypertension, and its mechanism may be related to the reduction of local Ang Ⅱ in plasma and myocardium and the inhibition of renin-angiotensin system (RAS) metabolism in vivo related.