山东大学学报(医学版) ›› 2017, Vol. 55 ›› Issue (2): 55-60.doi: 10.6040/j.issn.1671-7554.0.2016.288
谈红1,孟楠1,晋群1,苏莉2,张夏晓1,陈英剑3,郝哲1,刘晓红4
TAN Hong1, MENG Nan1, JIN Qun1, SU Li2, ZHANG Xiaxiao1, CHEN Yingjian3, HAO Zhe1, LIU Xiaohong4
摘要: 目的 探讨不同剂量培哚普利对兔急性心肌梗死(AMI)后外周循环内皮祖细胞(EPCs)的动员作用及心脏收缩功能的影响。 方法 建立兔心肌梗死模型,随机分为假手术组(n=7)、AMI组(n=6)、小剂量培哚普利组(n=6)和大剂量培哚普利组(n=6)。应用流式细胞技术分别检测1、3、7、14、28 d循环血中EPCs数量,并于模型建立28 d采用心脏多普勒超声技术测量每搏输出量(SV)、左心室射血分数(LVEF)和左心室短轴缩短率(LVFS),取梗死部位心肌组织行HE染色,观察各组心肌细胞的坏死及紊乱程度。 结果 AMI后经培哚普利干预,兔循环血中EPCs水平显著升高,大剂量培哚普利组效果显著(P<0.05)。AMI 28 d,AMI组与假手术组相比较,LVFS、SV、LVEF显著减低,经培哚普利干预后各指标显著增高,大剂量培哚普利组增高显著(P<0.05)。AMI组、小剂量培哚普利组和大剂量培哚普利组EPCs与LVEF呈相关性(R=0.468, P=0.05)。HE染色显示,与假手术组相比,AMI组心肌细胞基本被瘢痕组织替代,且其间有较多淋巴细胞浸润,小剂量培哚普利组见少量固缩心肌细胞及较多瘢痕组织,细胞肿胀变性及紊乱程度减轻,大剂量培哚普利组改善更为明显,可见较多正常心肌细胞存在及少量瘢痕组织。 结论 培哚普利可促进兔AMI后外周循环血中EPCs动员,提高LVEF、LVFS、SV,改善心功能,降低心肌细胞坏死及紊乱程度,且大剂量培哚普利干预效果更为显著,心脏收缩改善程度可能与EPCs水平有一定相关性。
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