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目的从血流动力学和心肌胶原增生等方面探讨复方芪丹液干预急性心肌梗死(AMI)后心室重构(VR)的作用机理。方法结扎中国小型猪冠状动脉左前降支造成AMI模型,随机分为假手术组、模型组、复方芪丹液大、小剂量组和开搏通组,分别灌胃不同药物或生理盐水。4周后观察小型猪血压(BP)、左室内压(LVP)、左室内压上升最大速率(dp/dtmax)、心肌组织肾素、AngⅡ、总胶原、Ⅲ型前胶原、Ⅳ型胶原及层粘连蛋白含量,血清透明质酸及心肌组织病理改变。结果与模型组比较,中药大剂量组LVP、BP、dp/dtmax值明显升高,心肌层粘连蛋白和AngⅡ含量明显降低(P<0.05,P<0.01);中药小剂量组LVP显著升高(P<0.05);开博通组LVP及dp/dtmax值显著升高,心肌AngⅡ含量明显降低(P均<0.05);各给药组血清透明质酸水平及心肌总胶原均有显著下降(P<0.01)。Ⅲ型前胶原和Ⅳ型胶原水平各组间差异无统计学意义。结论复方芪丹液可提高中国小型猪AMI 4周后LVP、dp/dtmax,增加心肌收缩力,改善血流动力学,降低心肌AngⅡ水平,减少胶原沉积,进而减轻AMI后VR。
Objective To investigate the mechanism of compound Qi Dan Ye intervention in ventricular remodeling (VR) after acute myocardial infarction (AMI) in terms of hemodynamics and myocardial collagen hyperplasia. Methods The AMI model was induced by ligation of the left anterior descending coronary artery in Chinese miniature pigs and randomly divided into sham-operated group, model group, compound QLD, small-dose group, and captopril group. Each drug or saline was given by gavage. After 4 weeks, blood pressure (BP), left ventricular pressure (LVP), maximum rate of left ventricular rise (dp/dtmax), myocardial tissue renin, AngII, total collagen, type III procollagen, type IV collagen, and layer were observed in miniature pigs. The content of fibronectin, serum hyaluronic acid and myocardial histopathological changes. Results Compared with the model group, the LVP, BP, dp/dtmax values of the high-dose Chinese medicine group significantly increased, and the laminin and AngII contents of the myocardium decreased significantly (P<0.05, P<0.01); the LVP of the low-dose Chinese medicine group was significantly increased ( P<0.05);Kaibotong group LVP and dp/dtmax values were significantly increased, myocardial AngII content was significantly reduced (P<0.05); serum levels of hyaluronic acid and total collagen in each drug group were significantly decreased (P <0.01). There was no significant difference in the levels of type III procollagen and type IV collagen between the groups. Conclusion Compound Danshen liquid can improve LVP, dp/dtmax, increase myocardial contractility, improve hemodynamics, decrease myocardial Ang II level, and reduce collagen deposition in AMI after 4 weeks in AMI of Chinese miniature piglets, and then reduce VR after AMI.