伊贝沙坦对缺血再灌注心律失常的作用实验研究

目的:探讨血管紧张素Ⅱ受体拮抗剂伊贝沙坦对缺血再灌注心律失常的作用及其机制。方法:32只Sprague-Dawley雄性大鼠分为缺血/复灌对照组,缺血/复灌+伊贝沙坦(100umol/L)组,缺血/复灌+伊贝沙坦(50umol/L)组,缺血/复灌+伊贝沙坦(100umol/L)+CsA(1umol/L)组,每组8只。观察各组心脏离体灌注下左室发展压(LVDP)、左室舒张末压(LVEDP)、心率(HR)、最大收缩/舒张速率(±dP/dtmax)、冠脉流量(CF)、灌流液乳酸脱氢酶(LDH)及心律失常评分。结果:单用伊贝沙坦组LVDP、LVEDP、LDH及心律失常评分显著低于缺血/复灌对照组(P<0.01);±dP/dtmax、CF显著高于缺血/复灌对照组(P<0.05),合灌环胞菌素A可以部分甚至全部逆转伊贝沙坦的作用。结论:伊贝沙坦对离体大鼠缺血/再灌注心肌有保护作用,减少再灌注心律失常发生,部分可能是通过激活钙调神经磷酸酶起作用。

Study of the Effect of Irbesartan on Ischemia-reperfusion Arrhythmia

Objective To explore the effect and mechanism of angiotensin II receptor antagonist irbesartan on ischemia-reperfusion arrhythmia in rats.Methods 32 male Sprague-Dawley rats were divided into ischemia/reperfusion control group（I/R group）,ischemia/reperfusion＋irbesartan（100umol/L） group（I/R＋irbesartan 100 group）,ischemia/reperfusion＋irbesartan（50umol/L）group（I/R＋irbesartan 50 group）,ischemia/reperfusion＋irbesartan（100umol/L）＋Cyclosporin A（CsA）（1umol/L）group（I/R＋irbesartan＋CsA group）,each group had 8 rats.Using isolated perfused heart in each group,left ventricular developed pressure（LVDP）,left ventricular end-diastolic pressure（LVEDP）,heart rate（HR）,maximal rise/fall rate of left ventricular pressure（±dP/dtmax）,coronary flow（CF）, perfusion fluid lactate dehydrogenase（LDH） and arrhythmia score were measured. Results LVDP,LVEDP,LDH and arrhythmia score were significantly lower in I/R＋irbesartan 50 group and I/R＋irbesartan 100 group than those in I/R group（P0.01）,and dP/dtmax,CF were markedly higher in I/R＋irbesartan 50 group and I/R＋irbesartan 100 group than those in I/R group（P0.05）.Cyclosporin A can reverse in part or completely the role of irbesartan.Conclusions Irbesartan has a protective effect on the isolated ischemia/reperfusion rat heart,reducing arrhythmias during reperfusion,it may partly be through activation of calcineurin enzyme.