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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。
Objective To investigate the relationship between intracoronary RAS and RAS in type I and type III collagen after myocardial infarction, and to provide some reference for clinical use by using it with low affinity of ACE for myocardial ACE and higher perindopril intervention data. Methods Immunohistochemistry and automatic image analysis system were used to observe the changes of type Ⅰ and type Ⅲ collagen with intervention of ACEI with different affinity to myocardium. Results The effect of two different ACEIs on the collagen in non-infarct area was different after MI. Perindopril with high affinity to cardiac ACE could inhibit the collagen type Ⅰ and Ⅲ reconstruction of NIA, while the low-affinity of itrafenib could not. Both drugs had no significant effect on the contents and proportions of Collagen Ⅰ and Ⅲ in infarcted area. Conclusion The different affinity of ACEI may play an important role in myocardial collagen after myocardial MI, which may be attributed to the difference in the affinity of myocardial ACE between them. It suggests that RAS is closely related to cardiac RAS after MI, but not by cyclic RAS.