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目的探讨心衰犬血浆肾素活性(plasma renin activity,PRA)、脑钠肽(brain natriuretic peptide,BNP)、肾血流的变化及高渗盐水配合速尿对其的影响。方法用快速心室起搏法建立心衰犬模型,随机分为假手术组(n=6)、对照组(n=6)、HSS组(n=6)、速尿组(n=6)、HSS +速尿组(n=7),分别在起搏前、起搏6周、盐水治疗2周后用放免法观测PRA、BNP;多普勒超声心动检查,测量左室舒张末径(LVEDD).左室收缩末径(LVESD),射血分数(EF)、心输出量(CO)、肾脏血浆流量(RBF)。结果起搏6周后,对照组犬与假手术组比较.心脏超声下心功能显著恶化,RBF明显下降,血浆PRA、BNP水平显著升高。上述指标均具有统计学意义(P<0.05)。高渗盐水+速尿组与对照组比较,LVEF、CO、RBF显著增加,血浆PRA、BNP水平降低明显(P<0.05);高渗盐水组、速尿组各指标无明显变化。结论高渗盐水配合速尿可改善心衰犬心功能,增加其肾脏血流量,对改善心衰犬已降低的肾灌注和已激活的RAS系统有积极意义。
Objective To investigate the changes of plasma renin activity (PRA), brain natriuretic peptide (BNP) and renal blood flow in dogs with heart failure and the effects of hypertonic saline with furosemide on them. Methods Rapid heart ventricular pacing was used to establish a model of heart failure dogs, which were randomly divided into sham operation group (n = 6), control group (n = 6), HSS group (n = 6) HSA + furosemide group (n = 7) .PAVA and BNP were measured by radioimmunoassay before pacing, 6 weeks after pacing and 2 weeks after saline treatment, respectively. Doppler echocardiography was performed to measure left ventricular end-diastolic diameter ), LVESD, EF, CO, and RBF. Results After 6 weeks of pacing, the heart function of the dogs in the control group was significantly worsened than that in the sham-operated group, the RBF was significantly decreased and the levels of plasma PRA and BNP were significantly increased. The above indicators were statistically significant (P <0.05). Compared with the control group, the levels of LVEF, CO and RBF in hypertonic saline + furosemide group increased significantly, and the levels of plasma PRA and BNP decreased significantly (P <0.05). There was no significant change in each index in hypertonic saline group and furosemide group. Conclusions Hypertonic saline combined with furosemide can improve heart function of heart failure dogs and increase renal blood flow, which is of positive significance to improve renal perfusion and activated RAS system in dogs with heart failure.