氯沙坦逆转自发性高血压大鼠心肌纤维化的实验研究

目的 实验研究观察氯沙坦对自发性高血压大鼠（SHR）心肌纤维化的逆转作用。方法 24只雄性16周龄的SHR分为动物对照组（SHR-C16），自然病程对照组（SHR-C28）和氯沙坦治疗组（SHR-L28），另用16只同周龄雄性WKY大鼠对照（WKY-C16、WKY-C28）。与对照组比较观察用药12周后血压，左室重量指数，左室胶原浓度和心肌胶原Ⅰ/Ⅲ型批值。结果 与WKY组大鼠相比较，SHR-C16组和SHR-C28组存在高血压，心肌肥厚和心肌胶原Ⅰ/Ⅲ型比值的增加，与SHR-C28组相比，SHR-L28组血压，左室重量指数，左室胶原浓度和心肌胶原Ⅰ/Ⅲ型的比值均显著降低。结论 氯沙坦不仅可以有效地降低SHR大鼠的血压，逆转左室肥厚，还能预防心肌纤维化的发生。     

硝苯地平对自发性高血压大鼠血管内皮细胞的保护作用

背景研究表明,硝苯地平能够改善血管内皮细胞功能,而对于其扩张血管的机制,目前仍在进一步的研究中. 目的观察硝苯地平控释剂对自发性高血压大鼠(SHR)一氧化氮(NO)及诱导性一氧化氮合酶(iNOS)的影响.设计以实验动物为研究对象的观察对比研究.单位一所医学院的动物实验中心.材料本实验于2002-04/2002-05在山东大学医学院动物实验中心完成.实验动物为近交SHR大鼠21只,体质量(300±20)g,由山东大学医学院实验动物中心提供,清洁级.随机分为3组,即对照组、正常剂量组、低剂量组,每组7只. 方法对照组、正常剂量组和低剂量组分别灌胃生理盐水10 mL/kg、硝苯地平控释剂(拜新同)溶液(0.3 g/L)10 mL/kg和3 mL/kg,1次/d,连续15 d.末次给药后摘眼球取血并取大鼠心、肺分别测定血清NO和iNOS的含量.主要观察指标各组大鼠的NO含量、iNOS活性比较.结果灌胃15 d后,正常剂量组的NO含量与对照组、低剂量组比较,差异均有显著性意义(P<0.01);正常剂量组心、肺组织块中iNOS活性降低,与对照组和低剂量组比较差异均有显著性意义(P<0.01,P<0.05).结论硝苯地平可在降低血压的同时,提高血清NO的含量,并且能对抗血压增高所造成的iNOS的活性增强(或二者互为因果).     

自发性高血压大鼠血浆一氧化氮水平的变化

背景有关高血压与一氧化氮关系的研究主要为单一时间的对照研究,但随着血压的改变一氧化氮如何变化的研究较少.目的观察自发性高血压大鼠(spontaneouly hypertensive rats,SHR)血浆一氧化氮浓度的变化,探讨一氧化氮与高血压发生发展的关系,为判断高血压的预后提供理论依据.设计非随机对照的实验研究.地点、材料和干预实验在广州暨南大学完成.选择SHR 30只,雌性6只,雄性9只(高血压组);大鼠WKY 30只,雌性7只,雄性8只(对照组).分别饲养3,6和12个月,测定血压,用硝酸银还原法测定两组大鼠血浆中一氧化氮的含量.主要观察指标观察随着高血压的不断发展,自发性高血压大鼠血浆一氧化氮浓度的变化.结果①血压变化各时期对照组大鼠血压差异无显著性意义,介于(135.0±9.8)～(147.8±11.3)mmHg;高血压组大鼠血压随着月龄增加逐渐升高,12个月达(197.3±7.5)mmHg,各时间点均明显高于对照组大鼠(t=4.132～7.921,P＜0.01).②血浆一氧化氮浓度的变化对照组大鼠血浆一氧化氮浓度各时间点差异无显著性意义(P＞0.05),维持在(11.5±3.9)～(14.4±3.4)μmol/L水平;高血压组大鼠血浆一氧化氮浓度在3,6个月分别为(16.6±4.5)和(18.5±4.2)μmol/L,明显高于对照组大鼠,但在12个月却明显较对照组大鼠低[(9.3±3.6)μmol/L](t=3.890,P＜0.01),同组内与3,6个月比较亦显著减少(t=3.890,P＜0.01).结论在高血压发生和发展过程中血浆一氧化氮存在反应性升高的变化,而在高血压的后期,一氧化氮的合成明显不足,这种变化可能与高血压的预后有关.     

硝苯地平对自发性高血压大鼠血管内皮细胞的保护作用

背景：研究表明，硝苯地平能够改善血管内皮细胞功能，而对于其扩张血管的机制，目前仍在进一步的研究中。目的：观察硝苯地平控释剂对自发性高血压大鼠(SHR)一氧化氮(NO)及诱导性一氧化氮合酶(iNOS)的影响。设计：以实验动物为研究对象的观察对比研究。单位：一所医学院的动物实验中心。材料：本实验于2002—04／2002—05在山东大学医学院动物实验中心完成。实验动物为近交SHR大鼠21只，体质量(300&;#177;20)g，由山东大学医学院实验动物中心提供，清洁级。随机分为3组．即对照组．正常剂量组、低剂量组，每组7只。方法：对照组、正常剂量组和低剂量组分别灌胃生理盐水10mL／kg、硝苯地平控释剂(拜新同)溶液(0．3g／L)10mL／kg和3mL／kg，1次／d，连续15d。末次给药后摘眼球取血并取大鼠心、肺分别测定血清NO和iNOS的含量。主要观察指标：各组大鼠的NO含量、iNOS活性比较。结果：灌胃15d后，正常剂量组的NO含量与对照组、低剂量组比较，差异均有显著性意义(P&;lt;0．01)；正常剂量组心、肺组织块中iNOS活性降低，与对照组和低剂量组比较差异均有显著性意义(P&;lt;0．01，P&;lt;0．05)。结论：硝苯地平可在降低血压的同时，提高血清NO的含量，并且能对抗血压增高所造成的iNOS的活性增强(或二者互为因果)。     

显微精索去神经术治疗特发性慢性睾丸痛的围手术期护理

目的 总结特发性慢性睾丸痛患者行显微精索去神经术的围手术期护理经验.方法 回顾分析在本院接受显微精索去神经术的2例特发性慢性睾丸痛患者的临床资料,包括术前、术后的疼痛评分、心理状况评估及手术切口护理,总结相关护理经验.结果 2例患者术后疼痛明显缓解,无切口感染,心理稳定,均于术后1周左右出院.结论 周密的围手术期护理是此类患者显微手术后顺利康复的重要环节.     

基质金属蛋白酶-9与自发性高血压大鼠心肌纤维化的相关性研究

目的:探讨基质金属蛋白酶-9(MMP-9)与自发性高血压大鼠(SHR)心肌纤维化的相关性。方法:将16只14周龄雄性SHR随机平分为ACEI组和对照组,另以8只同龄雄性SD大鼠作为正常对照组。ACEI组以卡托普利100mg/(kg.d)灌胃,SHR对照组不灌药,于灌药12周后麻醉下取出大鼠心脏。免疫组化分析MMP-9、Collagen和的表达;RT-PCR检测MMP-9mRNA表达;MASSON染色测量胶原容积分数(CVF);碱水解法测定羟脯氨酸(Hypro)含量。结果:(1)SHR对照组LVI、CVF、Hypro、MMP-9、Collagen和的表达明显高于正常对照组(P<0.01);相对于SHR对照组,ACEI组各参数则显著降低(P<0.05);(2)MMP-9与上述指标呈高度正相关(P<0.01)。结论:MMP-9与SHR心肌纤维化密切相关,ACEI能抑制MMP-9的表达。     

易卒中型自发性高血压大鼠大脑中动脉血管平滑肌细胞膜电位的特性

背景：动脉血管平滑肌细胞膜电位的微小变化就可以导致张力的显著性改变，膜去极化与高血压形成有密切关系。目的：研究易卒中型自发性高血压大鼠大脑中动脉平滑肌细胞的静息膜电位（Em）及其对血管活性物质KCl、去甲肾上腺素的反应性。设计：对照分析动物实验。单位：山东省医学科学院药物研究所。材料：雄性卒中型自发性高血压大鼠18只和雄性Wistar大鼠26只。方法：①两组大鼠经乌拉坦（1g／kg）腹腔注射麻醉，迅速取出大脑，剥离出大脑中动脉，应用细胞内微电极记录血管平滑肌细胞膜电位。（多分别观察不同浓度的KCl（10，20，50mmol／L），去甲肾上腺素（10^-710^-6，10^-5mol／L）对血管平滑肌细胞膜电位的影响。主要观察指标：①两组大鼠血管平滑肌细胞膜电位。②不同浓度的KCl和去甲肾上腺素对血管平滑肌细胞膜电位的影响。结果：①卒中型自发性高血压大鼠膜电位明显低于Wistar大鼠[（-48．2&;#177;3．1），（-64．4&;#177;4．3）mv]。②KCl（10，20，50mmol／L）和去甲肾上腺素（10^-7，10^-6，10^-5mol／L）均引起大脑中动脉膜电位去极化，且皆呈剂量依赖式特点；与Wistar大鼠比较，卒中型自发性高血压大鼠的大脑中动脉反应性明显增强。结论：卒中型自发性高血压大鼠大脑中动脉血管平滑肌细胞膜电位较低，对KCl和去甲肾上腺素的反应性明显高于Wistar大鼠。     

超声评价非诺贝特对自发性高血压大鼠心肌重构的干预作用

目的 应用超声技术评价非诺贝特对自发性高血压大鼠心肌重构的影响。方法 自发性高血压大鼠（spontaneous hypertensive rats，SHR）22只随机分为SHR用药组（12只）和SHR未用药组（10只），同周龄Wistar—kyoto（WKY）大鼠10只作为正常对照。非诺贝特治疗8周，分别于实验前后进行超声心动图检查，8周末处死动物进行组织学检查。结果实验后，与WKY组相比，SHR未用药组室壁厚度、左室相对质量显著增加（P＜0．01），二尖瓣口血流流速曲线E／A值明显减小（P＜0．01），E峰减速时间明显延长（P＜0．05）；SHR用药组与SHR未用药组相比以上指标均有明显改善（P＜0．05）。SHR未用药组室间隔、左室后壁的平均声学强度（AID、心包校正的声学强度明显增高（P＜0．01），峰一峰强度明显降低（P＜0．01）；SHR用药组与SHR未用药组相比以上声学密度指标均有明显改善（P＜0．05）。超声所计算的左室相对质量与实体标本测值具有较高的相关性（r=0．729，P＜0．001）。结论 非诺贝特具有干预SHR心肌重构的作用，声学密度技术结合常规超声心动图能较全面、准确评价此作用。     

重度哮喘患者行支气管腔内冷冻去神经术治疗患者一例的围术期护理

目的 总结国内首例采用支气管腔内冷冻去神经术(bronchial cryo-denervation, BCD)治疗重度哮喘患者的护理经验。方法 回顾性分析上海市东方医院呼吸科收治的1例重度哮喘患者接受2次BCD治疗患者的临床资料。结果 经2次BCD治疗及护理后,患者临床症状得到有效控制,哮喘控制问卷评分、哮喘控制测试评分、6 min步行试验、肺功能均有明显改善,随访期间无并发症发生。结论 术前专科评估、术中监测气道变化、术后注重气道管理和呼吸康复训练及并发症的预防和处理,可以提高该类患者BCD的成功率并保证其临床疗效。     

Anesthetic influences on myocardial and hepatic energy metabolism in hemorrhaged spontaneous hypertensive rats.

Twenty four spontaneously hypertensive rats (SHRs) were used to assess the influence of anesthetics on myocardial and hepatic energy metabolism after hemorrhage. They were divided into four groups: a control group and three others which received pentobarbital (60 mg.kg-1 ip), 2.2% enflurane, or 1.4% isoflurane. Following a 10-min stabilisation period, blood (2 ml.100 g body weight-1) was gradually withdrawn over a 5-min period from a femoral artery. Thirty minutes after the induction of hemorrhage, the heart and liver were removed, and myocardial and hepatic metabolites (ATP, lactate, pyruvate, and glycogen) were measured by the enzymatic methods. Metabolic acidosis and decreased hematocrit were noted in all groups after hemorrhage. The mean arterial pressure in rats receiving anesthetics decreased significantly in comparison with the control group. There were significant increases of myocardial and hepatic lactate/pyruvate ratios in rats receiving enflurane when compared with controls. These results suggest that enflurane may be more detrimental than other anesthetics to the maintenance of anesthesia in hypovolemic SHRs.     

缬沙坦、螺内酯及其联用对逆转自发性高血压大鼠心肌重塑的影响

目的　在受体水平阻断肾素 血管紧张素 醛固酮系统 ,比较缬沙坦、螺内酯以及二者联用对逆转自发性高血压大鼠 (SHRs)心肌重塑的作用 ,来探讨高血压性心肌重塑的可能机制。方法　 12周龄SHRs 32只 ,随机分成 4组 ,即SHR对照组、缬沙坦组、螺内酯组、二者联用 ,每组 8只 ;另设WKY大鼠(8只 ,周龄及体重同SHRs)为正常对照。Tail cuff法测血压 ,每周一次。 4个月后处死大鼠 ,测定左心室重量指数 (LVMI)、心肌胶原含量 (MCC)及心肌胶原容积分数 (CVF)。放免法检测血浆及心肌醛固酮水平。结果　与SHR对照组比较 ,螺内酯组收缩压稍降低 (P >0 0 5 ) ,缬沙坦组收缩压降低 (P <0 0 5 ) ,联用组收缩压显著降低 (P <0 0 1) ;三组的LVMI均降低 (P <0 0 5 ) ;三组的心肌胶原含量 (MCC)和心肌胶原容积分数 (CVF)下降 (P <0 0 5 ) ,其中 ,联用组效果优于缬沙坦组和螺内酯组 ;缬沙坦组的血浆、心肌醛固酮水平稍下降 (P >0 0 5 ) ,螺内酯组的血浆醛固酮水平显著升高 (P <0 0 5 )、心肌醛固酮水平显著下降 (P <0 0 1) ;联用组的心肌醛固酮水平显著下降 (P <0 0 1) ,与WKY鼠组接近。结论　首次证实在SHRs中长期使用血管紧张素 1型受体 (AT1)拮抗剂可导致血浆及心肌醛固酮逃逸。尽管螺内酯单独使用有效 ,但缬沙坦     

Enalapril attenuates cardiorenal damage in nitric-oxide-deficient spontaneously hypertensive rats

Stereological structural alterations of the heart and kidney were studied in four groups (n=5) of spontaneously hypertensive rats (SHRs) treated for 30 days: (i) control, (ii) NG-nitro-L-arginine methyl ester [L-NAME; nitric oxide (NO) synthesis inhibitor] alone, (iii) enalapril alone and (iv) L-NAME plus enalapril. Blood pressure (BP) was elevated significantly in NO-deficient SHRs (rats receiving L-NAME) or significantly lower in enalapril-treated SHRs. Co-administration of L-NAME and enalapril caused a 20% decrease in BP compared with untreated SHRs. NO-deficient SHRs had a decrease in body mass, but this loss of body mass was prevented efficiently in the enalapril-treated group. Enalapril treatment decreased the left ventricular (LV) mass index in SHRs, even in animals with NO synthesis blocked. NO deficiency in SHRs caused a larger decrease in the number of LV cardiomyocyte nuclei, which had a negative correlation with both LV mass index and BP. The volume-weighted glomerular volume (VWGV) separated the SHRs into two groupings: (i) control and NO-deficient SHRs, and (ii) enalapril- and L-NAME plus enalapril-treated SHRs. There was a significant difference between these two groupings, with VWGV being more than 15% smaller in the latter compared with the former grouping. The present findings reinforce the evidence that enalapril efficiently treats genetic hypertension, and demonstrate that this effect is observed even when NO synthesis is inhibited. Enalapril administration also decreases cardiac and renal structural damage caused by genetic hypertension, as well as by the interaction between genetic hypertension and NO deficiency.     

Renal kallikrein activity in rats developing spontaneous hypertension

1. Spontaneously hypertensive rats (SHR) excrete less kallikrein in urine than Wistar-Kyoto rats (WKY) during the developmental phase of hypertension. The present study was designed to examine whether the urinary defect is related to abnormalities in the renal kallikrein content in this hypertensive model. 2. Active and total kallikrein were measured (amidolytic assay) in the renal cortex of newborn and 4-, 8- and 12-week-old SHR and age-matched WKY. Active and total kallikrein were also measured in urine at the same ages, except at birth. 3. Tissue active kallikrein was significantly lower in SHR at birth, representing on average 53% of the values in WKY expressed as content per total cortex weight. Tissue total kallikrein did not differ between newborn SHR and WKY. 4. SHR at 4, 8 and 12 weeks of age had lower urinary active and total kallikrein excretion. Tissue active akllikrein, but not total kallikrein, was higher than in age-matched WKY per g of cortex weight or per mg of protein, whereas both tissue active and total kallikrein were lower in SHR when expressed as content per total cortex weight. At these three ages, active kallikrein represented, on average 86%, while total kallikrein represented 77%, of the values in age-matched WKY. 5. Our results indicate a defect in prokallikrein activation rather than in kallikrein synthesis in the renal cortex of SHR at birth. The reduction in urinary kallikrein excretion during the developmental phase of hypertension in young SHR is similar to the reduction observed in the renal tissue.     

Renal kallikrein content of spontaneously hypertensive rats.

1. The kallikrein content of kidneys from spontaneously hypertensive and normal rats at birth and at age 37 days was determined. 2. Kallikrein values were significantly lower in the hypertensive rats. 3. It is suggested that the lowered kallikrein may be related to the development of hypertension.     

自发性高血压大鼠血管内皮功能不全发生机理实验研究

目的探讨自发性高血压大鼠(SHR)血管内皮功能不全的发生机理。方法用SHR作为实验组,Wistar-Kyoto(WKY)大鼠作为正常对照组,采用尾动脉测压方法测定SHR和WKY大鼠血压;铜离子活化镉还原法测定血清中NO3-浓度;放射免疫分析法测定大鼠血或动脉组织中cGMP和内皮素(ET)水平。结果与WKY大鼠比较,SHR血中ET和NO3-水平均明显降低(P<0.01);动脉组织中cGMP含量亦明显降低(P<0.01),ET含量略增加但无显著性差异(P>0.05)。结论SHR体内一氧化氮的生成或释放不足可能直接参与血管内皮功能不全的发生,而ET水平可能不起主要作用。