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目的 通过研究TNF α拮抗剂enbrel(EB)对于一种确切的心衰动物模型的疗效验证这样一个假设 :给予心衰大鼠慢性EB治疗能够减轻左心功能不全与左室重构并减低心肌IL 1β水平。方法 我们对 8只正常年龄对照的成年大鼠 (对照组 ) ,8只异丙肾上腺素诱导的心衰大鼠 (ISO组 )以及 8只经过EB治疗的异丙肾上腺素诱导的心肌损害大鼠 (EB组 )进行了心脏形态 ,收缩功能及细胞因子水平的测定。结果 EB组较ISO组左室舒张末期直径及收缩末期直径明显缩小而左室缩短率有明显提高 (分别为 9 2± 0 3mmvs 9 5± 0 2mm ,5 8± 0 5mmvs 6 5± 0 3mm ,0 37± 0 0 3vs 0 31± 0 0 2 ,P <0 0 5 ,P <0 0 1,P <0 0 1) ,但两组间舒张末期左室后壁厚度无明显差异 ;EB组左室收缩末压 ,dp/dtmax明显高于 (分别为 10 4 8± 4 6mmHgvs98 4± 4 9mmHg ,8395± 94 0mmHg/svs 6 898± 6 12mmHg ,P <0 0 5 ,P <0 0 1)而左室舒张末期压力 ,dp/dtmin,左室舒张期时间常数显著低于ISO组 (分别为 3 8± 0 6mmHgvs 7 1± 0 8mmHg ,- 5 96 3± 4 75mmHg/svs - 5 0 30± 316mmHg/s ,15 4± 0 8msvs 2 1 3± 1 4ms ,P <0 0 1)。虽然EB组心脏收缩功能已有明显改善 ,但与对照组相比仍有明显差距。EB组的左室体重比较对照组明
AIM To test the efficacy of the TNFα antagonist enbrel (EB) in an animal model of an exact heart failure to test the hypothesis that chronic EB treatment of heart failure rats can reduce left ventricular dysfunction and left ventricular remodeling and decrease myocardial IL 1β level. Methods Eight adult rats (control group), 8 isoproterenol-induced heart failure rats (ISO group) and 8 isoproterenol-induced myocardial damage rats (EB group) for the determination of cardiac morphology, systolic function and cytokine levels. Results Compared with ISO group, the diameter of left ventricular end-diastole and the diameter of end-systolic phase in EB group were significantly decreased and the shortening rate of left ventricle was significantly increased (92 ± 0 3mm vs 95 ± 0 2mm, 58 ± 0 5mm vs 65 ± 0 3mm, 0 37 ± 0 0 3vs 0 31 ± 0 0 2, P 0 05, P 0 01, P 0 01), but there was no significant difference in LV end-diastolic wall thickness between the two groups The end-systolic pressure, dp / dtmax, was significantly higher (10 4 8 ± 4 6 mmHg vs 98 4 ± 49 mmHg, 8395 ± 94 0 mmHg / s vs 6 898 ± 6 12 mmHg, P <0 05, P 0 01, respectively) The left ventricular end-diastolic pressure, dp / dtmin, and left ventricular diastolic time constant were significantly lower than those in the ISO group (38 ± 0 6 mmHg vs 7 1 ± 0 8 mmHg, -5 96 3 ± 4 75 mmHg / s vs -530 ± 316 mmHg, respectively / s, 15 4 ± 0 8 ms vs 2 1 3 ± 1 ms, P <0.01). Although systolic function in EB group has been significantly improved, but there is still a significant gap compared with the control group. Left ventricular weight in EB group compared with the control group