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慢性给予阿霉素诱导犬心脏疾病及维生素E和硒作为心脏保护剂的评估

Cardiac disease induced by chronic adriamycin administration in dogs and an evaluation of vitamin E and selenium as cardioprotectants.

作者信息

Van Vleet J F, Ferrans V J, Weirich W E

出版信息

Am J Pathol. 1980 Apr;99(1):13-42.

Abstract

Chronic adriamycin (ADR) intoxication was produced in three groups of beagle dogs by weekly intravenous injections (1 mg/kg body weight) for 20 weeks (cumulative dose 400 mg/sq m). Group A (6 dogs) received ADR only; Group B (6 dogs) were given ADR and weekly doses of vitamin E (17 mg/kg body weight) as alpha-tocopherol acetate; and Group C (6 dogs) received ADR and weekly doses of vitamin E as did Group B and selenium (0.06 mg/kg body weight as selenite). Each of the 18 dogs developed ADR-induced cardiomyopathy (CMY), and death occurred in 11 dogs during Weeks 17-20. Mortality was lowest in Group B (2 of 6), but no differences between groups were seen either in survival time of the dogs that died or in severity of CMY. Cardiomyopathy was more severe in dogs that died than in survivors. Congestive heart failure with transudation was present in 4 of 11 dogs that died. Cardiac histopathology was characterized by vacuolar degeneration of myocytes. Myocardial damage was most severe in the left ventricle and the ventricular septum, intermediate in the right ventricle and the left atrium, and least in the right atrium. Ultrastructural study showed that an early alteration in damaged myocytes was distention of sarcoplasmic reticulum to form sarcoplasmic vacuoles. Occasional damaged fibers had myofibrillar lysis and focal proliferation of sarcoplasmic reticulum. This study demonstrates that the dog offers a suitable model for studies of chronic ADR cardiotoxicity in man. The lack of cardioprotection from vitamin E and selenium supplementation fails to support the proposed role of lipoperoxidative damage in the development of chronic ADR-induced CMY.

摘要

通过每周静脉注射(1毫克/千克体重),持续20周(累积剂量400毫克/平方米),在三组比格犬中造成慢性阿霉素(ADR)中毒。A组(6只犬)仅接受阿霉素;B组(6只犬)接受阿霉素并每周给予维生素E(17毫克/千克体重,以醋酸α-生育酚形式);C组(6只犬)接受阿霉素,且如B组一样每周给予维生素E以及硒(0.06毫克/千克体重,以亚硒酸盐形式)。18只犬均发生了阿霉素诱导的心肌病(CMY),11只犬在第17至20周期间死亡。B组死亡率最低(6只中的2只),但在死亡犬的存活时间或CMY严重程度方面,各组之间未观察到差异。死亡犬的心肌病比存活犬更严重。11只死亡犬中有4只出现伴有漏出液的充血性心力衰竭。心脏组织病理学特征为心肌细胞空泡变性。心肌损伤在左心室和室间隔最为严重,右心室和左心房次之,右心房最轻。超微结构研究表明,受损心肌细胞的早期改变是肌浆网扩张形成肌浆空泡。偶尔受损的纤维有肌原纤维溶解和肌浆网局灶性增生。本研究表明,犬为研究人类慢性阿霉素心脏毒性提供了合适的模型。补充维生素E和硒未能提供心脏保护,这无法支持脂质过氧化损伤在慢性阿霉素诱导的CMY发生中所起的作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5bda/1903483/e05f736ed66f/amjpathol00230-0043-a.jpg

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