不同亲和力ACEI干预对MI后心肌胶原重建的影响

目的　利用对心肌ACE亲和力较低的伊那普利及较高的培哚普利干预探讨心肌梗塞后间质Ⅰ、Ⅲ型胶原重建同心内RAS、循环RAS的关系 ,并试图为临床用药提供一定参考资料。方法　采用免疫组化结合自动图象分析系统 ,借助对心肌不同亲和力的ACEI药物干预观察Ⅰ、Ⅲ型胶原变化。结果　MI后两种不同ACEI对非梗塞区胶原作用不同 ,对心脏ACE高亲和力的培哚普利可明显抑制NIA胶原Ⅰ、Ⅲ型重建 ,而低亲和力的伊那普利则不能。两药对梗塞区胶原Ⅰ、Ⅲ型含量和比例均无显著作用。结论　不同亲和力的ACEI对MI后心肌胶原作用的不同可能是由二者对心肌ACE亲和力差别所致 ,提示MI后间质胶原重建同心脏局部RAS关系密切 ,而循环RAS所起作用不大。

Effects of ACEI with different tissue affinities on the remodelling of cardiac collagen following myocardial infarction in rats

Objective To detect the relationship of type Ⅰ and Ⅲ collagen remodeling of the heart and circulation renin angiotensin system after myocardium infarction(MI). Methods By auto imagation analysis system, we used angiotensin converting enzyme inhibitor(ACEI) of different affinities to cardium to study the changes of collagen Ⅰ and Ⅲ. Results Perindopril(high affinity) and enalapril(low affinity) had different effects on non infarction area(NIA) after MI. Perindopril obviously inhibited collagen Ⅰ and Ⅲ remodeling in NIA, while Enalapril did not. Neither of them had significant effects on the contents of collagen Ⅰ and Ⅲ, and their ratio in infarction area. Conclusion Different effects on cardiac collagen of different ACEI may be related to their different tissue affinities. It suggests that cardiac interstitial collagen remodeling after MI relates to the cardiac RAS, but not to the RAS circulation.