CAJ | 학술논문

目的：探讨曲美他嗪与雷米普利单用及联合应用对慢性心力衰竭大鼠左心室心肌细胞凋亡情况以及半胱氨酸天冬氨酸蛋白酶3（Caspase-3）表达水平的影响。方法雄性Wistar大鼠50只随机分为假手术组、模型组、曲美他嗪组、雷米普利组和联合用药组（曲美他嗪＋雷米普利），每组10只。采用肾上腹主动脉缩窄法制作慢性心力衰竭模型，观察各组左心室舒张末压、左心室压力最大上升及下降速率（± dp/dtmax ）；TUNEL法检测心肌细胞凋亡指数；SP免疫组织化学法检测各组大鼠左心室心肌Caspase-3水平的表达，RT-PCR测定Caspase-3 mRNA水平。结果与模型组比较，曲美他嗪组、雷米普利组和联合用药组左心室舒张末压、心肌凋亡指数明显降低，± dp/dtmax明显升高，差异有统计学意义（P＜0．01），Caspase-3蛋白及 mRNA 表达水平明显降低，差异有统计学意义[（0．14±0．01、0．14±0．02和0．08±0．02）vs（0．22±0．02），（0.54±0．02、0．54±0．02和0．32±0．02）vs （0．91±0．02），P＜0．01]。结论曲美他嗪与雷米普利单用及联合应用均可有效改善心功能、抑制心肌细胞凋亡，联合用药的疗效优于单独用药。
목적：탐토곡미타진여뢰미보리단용급연합응용대만성심력쇠갈대서좌심실심기세포조망정황이급반광안산천동안산단백매3（Caspase-3）표체수평적영향。방법웅성Wistar대서50지수궤분위가수술조、모형조、곡미타진조、뢰미보리조화연합용약조（곡미타진＋뢰미보리），매조10지。채용신상복주동맥축착법제작만성심력쇠갈모형，관찰각조좌심실서장말압、좌심실압력최대상승급하강속솔（± dp/dtmax ）；TUNEL법검측심기세포조망지수；SP면역조직화학법검측각조대서좌심실심기Caspase-3수평적표체，RT-PCR측정Caspase-3 mRNA수평。결과여모형조비교，곡미타진조、뢰미보리조화연합용약조좌심실서장말압、심기조망지수명현강저，± dp/dtmax명현승고，차이유통계학의의（P＜0．01），Caspase-3단백급 mRNA 표체수평명현강저，차이유통계학의의[（0．14±0．01、0．14±0．02화0．08±0．02）vs（0．22±0．02），（0.54±0．02、0．54±0．02화0．32±0．02）vs （0．91±0．02），P＜0．01]。결론곡미타진여뢰미보리단용급연합응용균가유효개선심공능、억제심기세포조망，연합용약적료효우우단독용약。
Objective To study the effect of trimetazidine or ramipril alone and their combination on myocardial cell apoptosis and Caspase-3 expression in chronic heart failure rats .Methods Fifty male Wistar rats were randomly divided into sham operation group ,model group ,trimetazidine group ,ramipril group and combined treatment (trimetazidine and ramipril ) group (10 in each group) .A chronic heart failure model was established by suprarenal aortic constriction .LVEDP and ± dp/dtmax were recorded ,AI of myocardial cells was assayed by TUNEL ,expressions of Caspase-3 protein and mRNA were detected by SP immunohistochemistry and RT-PCR respec-tively in different groups .Results The LVEDP ,AI and the expression levels of Caspase-3 protein and mRNA were significantly lower in trimetazidine group ,ramipril group and combined treat-ment group than in model group (0 .14 ± 0 .01 vs 0 .22 ± 0 .02 ,0 .14 ± 0 .02 vs 0 .54 ± 0 .02 ,0.08 ± 0 .02 vs 0 .54 ± 0 .02 ,and 0 .32 ± 0 .02 ,0 .91 ± 0 .02 ,P<0 .01) while the ± dp/dtmax was significant-ly higher in trimetazidine group ,ramipril group and combined treatment group than in model group .Conclusion Trimetazidine or ramipril alone and their combination can effectively improve cardiac function and inhibit myocardial cell apoptosis in chronic heart failure rats .T he therapeutic effect of combined trimetazidine and ramipril is better than that of trimetazidine or ramipril alone .