卡维地洛与倍他乐克防治大鼠AMI左室重构作用的比较

Comparative Effects of Carvedilol and Metoprolol in Preventing from Left Ventricular Remodeling After Acute Myocardial Infarction in Rats

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摘要目的对比卡维地洛及倍他乐克对大鼠急性心肌梗死AMI左室重构LVRM的防治作用。方法105只AMI术后成活的雌性SD大鼠随机分成AMI对照n=35、卡维地洛1mg/kg·dn=35和倍他乐克2mg/kg·dn=35三组。另设假手术组。给药4周后行血流动力学测定和病理分析。去除死亡及梗死面积<35%或>55%者,最终46只大鼠资料完整,在以上各组分别为11,12,11和12只。结果与假手术组相比,AMI组的左室舒张末压LVEDP、容积LVV、重量LVW显著增加P<0.05～0.001左室内压最大上升和下降速率±dp/dt及其校正值±dp/dt/LVSP显著降低P<0.01～0.001。与AMI组相比,卡维地洛和倍他乐克组的LVEDP及LVV均显著降低P均<0.001,±dp/dt及±dp/dt/LVSP均显著升高P<0.05～0.001,而LVW和RVW仅在卡维地洛组显著减轻P均<0.05～0.01。结论1、卡维地洛能有效抑制大鼠AMI左室重构并改善血流动力学和左室功能,2、倍他乐克与卡维地洛的作用相似,但对心室肥厚似无抑制作用。 Objective To compare the effects of carvedilol and metoprolol in preventing from left ventricular remodeling(LVRM)after acute myocardial infarction(AMI) in rats.Methods Twenty-four hours after ligating left coronary artery,105 surviving female SD rats were randomly assigned to AMI control,car-vedilol1mg /(kg·d)and metoprolol2mg /(kg·d)groups.Sham-operated rats(n=16)wer e selected randomly as non-infarction control.After four weeks of drugs therap y,hemodynamic studies and path-ologic analysis were performed.Exclusive of MI size<35%or>55%,complete experimental variables were obtained in46rat s,which were comprised of AMI (n=11),carvedilol(n=12),metoprolol(n =11),and Sham-operated (n=12)groups.Results Compared with sham-operat ed group,left ventricular(LV)end diastolic pressure(LVEDP),volume (LVV)a nd weight (LVW)were all significantly increased(P<0.05～0.001),wh ile maximal rate of rise and fall(±dp/dt)of LV pressure as well as their cor- rec ted values(±dp/dt /LVSP)were all significantly decreased (P<0.01～ 0.001)in AMI group.In com parison with AMI group,the LVEDP and LVV wer e all significantly decreased(all P<0.001),while±dp/dt and±dp/dt /LV SP were significantly increased(P<0.05～0.001)in both carvedilol and me toprolol group,with LVW and RVW only decreased in carvedilol group (P<0 .05～0.01).Conclus -ions 1.Carvedilol can effec tively attenuate LVRM ,and improve hemodynamics and LV function after AMI in rats,2.Metoprolol ha s equivalent beneficial effects as carvedilol on hemodynamics,LV dilata-tion a nd function,but not LV hypertrophy.