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目的 研究苯妥英钠促进结缔组织增生的特殊药理作用对心肌梗死后组织修复的影响。方法 采用大鼠心肌梗死模型 ,分为苯妥英钠、卡托普利、苯妥英钠 +卡托普利、手术对照 (分为14天和 2 1天两组 )和假手术组 ;用苦味酸天狼猩红 偏振光法 ,对心室组织胶原沉积量、交联程度及分布情况进行定性及定量分析 ;并研究苯妥英钠不同浓度对大鼠心脏成纤维细胞增殖活性、转化生长因子 β1(TGF β1)与胶原合成量的影响以及巨噬细胞在其中发挥的作用。结果 苯妥英钠在体外对心脏成纤维细胞增殖活性无明显影响 ,但可通过激活巨噬细胞对心脏成纤维细胞的增殖活性、TGF β1与胶原合成量产生正性影响 ,并具有一定量效关系 (r =0 86 5和r =0 816 ,P <0 0 5 ) ;苯妥英钠可使梗死区胶原交联程度明显增高 ,并可增加Ⅰ /Ⅲ型胶原比值 ,均达到与心肌梗死后 2 1天相当的水平 ,而对非梗死区无明显影响。结论 苯妥英钠可以促进心肌梗死后梗死区的组织修复过程 ,对非梗死区胶原代谢无明显影响 ,具有潜在的临床应用价值。
Objective To investigate the effect of phenytoin on the tissue repair after myocardial infarction by the special pharmacological action of promoting connective tissue hyperplasia. Methods The rat model of myocardial infarction was divided into phenytoin sodium, captopril, phenytoin + captopril, surgical control (divided into two groups of 14 days and 21 days) and sham operation group; Scarlet polarized light method was used to qualitatively and quantitatively analyze the collagen deposition, crosslinking degree and distribution of ventricular tissue. The effects of different doses of phenytoin on the proliferation of rat cardiac fibroblasts, the expressions of TGFβ1 and collagen The amount of synthesis and the role that macrophages play in it. Results Phenytoin had no significant effect on the proliferation of cardiac fibroblasts in vitro, but it had a positive effect on the proliferation of cardiac fibroblasts by stimulating the proliferation of cardiac fibroblasts, and had a dose-effect relationship r = 0 865 and r = 0 816, P <0 05). Phenytoin sodium significantly increased the degree of collagen cross-linking in the infarcted area and increased the ratio of type Ⅰ / Ⅲ collagen, which reached the level of 21 days after myocardial infarction A considerable level, while no significant impact on non-infarcted area. Conclusion Phenytoin sodium can promote the process of tissue repair in the infarct area after myocardial infarction, and has no obvious effect on the collagen metabolism in non-infarcted area, which has potential clinical application value.