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目的:观察活血药合用安神药对急性心肌梗死(AMI)大鼠心肌损伤的保护作用。方法:Wistar大鼠行冠状动脉左前降支结扎复制急性心肌梗死模型,分为假手术组、模型组、活血药组和活血药合用安神药组。给药组于造模当天连续给药至术后21 d,观察心脏射血分数(EF)和左心室缩短分数(FS)、左室舒张期内径(LVIDd)和左室收缩期内径(LVIDs)、心脏整体形态、HE染色及电镜观察等心功能和组织形态学变化。结果:和假手术组比较,模型组EF和FS显著下降(P<0.001),LVIDd,LVIDs明显增大(P<0.001),心肌梗死面积达左心室前壁的70%～90%,心肌纤维化、炎细胞浸润、肌纤维断裂和心肌细胞线粒体空泡样变等病理改变严重;和模型组比较,活血药和活血药合用安神药组EF和FS显著升高(P<0.05或P<0.01),LVIDd,LVIDs明显减小(P<0.05或P<0.01),心肌梗死面积约占左心室前壁的40%～60%,心肌纤维化、炎细胞浸润、肌纤维断裂和心肌细胞线粒体空泡样变等病理改变明显减轻;和活血药组比较,活血药合用安神药组EF和FS进一步升高,LVIDd,LVIDs进一步减小(P<0.05),心肌纤维化、炎细胞浸润、肌纤维断裂和心肌细胞线粒体空泡样变等病理改变进一步减轻。结论:活血药基础上合用安神药能进一步改善梗死后缺血心肌的结构和功能,有显著的增效作用,该作用可能与安神药的抗脂质过氧化,稳定心肌细胞膜和心肌线粒体膜,减轻心肌细胞损伤有关。
Objective: To observe the protective effect of Huoxue Medicine combined with Soothing Medicine on myocardial injury in rats with acute myocardial infarction (AMI). Methods: Wistar rats underwent left anterior descending coronary artery ligation and replication model of acute myocardial infarction. They were divided into sham operation group, model group, Huoxueyao group and Huoxueyao combined with Shenxide group. The administration group was administered continuously on the day of modeling until 21 days after operation. The ejection fraction (EF), left ventricular fractional shortening (FS), left ventricular diastolic dimension (LVIDd) and left ventricular systolic dimension (LVIDs) , Heart morphology, HE staining and electron microscopy and other cardiac function and histological changes. Results: Compared with the sham operation group, the EF and FS of the model group decreased significantly (P <0.001), LVIDd and LVIDs increased significantly (P <0.001), myocardial infarct size reached 70% -90% of the left ventricular anterior wall, (P <0.05 or P <0.01). Compared with the model group, the levels of EF and FS were significantly increased (P <0.05 or P <0.01) (P <0.05 or P <0.01). The area of myocardial infarction accounted for about 40% -60% of the anterior wall of the left ventricle. Myocardial fibrosis, inflammatory cell infiltration, myofibrillar fragmentation and mitochondrial vacuolar (P <0.05) .Compared with Huoxue Decoction, EF and FS of Huoxue Decoction combined with Shenliao Decoction increased further, LVIDd and LVIDs decreased (P <0.05), myocardial fibrosis, inflammatory cell infiltration, muscle fiber breakage and myocardial Mitochondrial vacuolar degeneration and other pathological changes further reduced. CONCLUSION: The combination of drugs for promoting blood circulation can further improve the structure and function of ischemic myocardium after myocardial infarction, and have a synergistic effect. This effect may be related to anti-lipid peroxidation of antitussive drugs, stabilization of myocardial cell membrane and myocardial mitochondrial membrane, Reduce myocardial cell damage related.