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长期使用卡维地洛可降低易患高血压性中风大鼠的死亡率和肾损伤。

Chronic carvedilol reduces mortality and renal damage in hypertensive stroke-prone rats.

作者信息

Barone F C, Nelson A H, Ohlstein E H, Willette R N, Sealey J E, Laragh J H, Campbell W G, Feuerstein G Z

机构信息

Department of Cardiovascular Pharmacology, SmithKline Beecham Pharmaceuticals, King of Prussia, Pennsylvania, USA.

出版信息

J Pharmacol Exp Ther. 1996 Nov;279(2):948-55.

PMID:8930204
Abstract

The effects of carvedilol, a novel vasodilating beta-blocker and antioxidant, and propranolol on survival, neurobehavioral deficits, cardiovascular parameters, plasma renin, plasma aldosterone levels and renal pathology were determined in stroke-prone spontaneously hypertensive rats. Stroke-prone spontaneously hypertensive rats were allowed access to 1% NaCl as the drinking solution and a high fat diet supplemented with carvedilol (1200 or 2400 ppm) or propranolol (2400 ppm). The control group consisted of stroke-prone spontaneously hypertensive rats placed on the same diet with no drug supplement. Animals fed propranolol had a blood level of 864 +/- 68 ng/ml, whereas carvedilol-fed animals had blood levels of 24 +/- 4 ng/ml at 1200 ppm and 471 +/- 145 ng/ml at 2400 ppm. Carvedilol and propranolol treatment resulted in significant beta adrenoceptor blockade. Both compounds reduced heart rate, but had no significant effects on systolic arterial blood pressure. Carvedilol- and propranolol-treated animals also exhibited significant, prolonged protection from neurobehavioral deficits and mortality (P < .01). Elevated plasma renin activity and aldosterone levels seen in untreated controls were significantly decreased by propranolol (P < .05), and to a considerably greater extent by the same dose of carvedilol (P < .01). Carvedilol decreased renal histopathological damage and cardiac hypertrophy to a greater extent (P < .01) than propranolol (at equal doses). Both carvedilol (P < .01)- and propranolol (P < .01)-treated animals had considerably reduced renal damage at 18 weeks of treatment. Carvedilol reduced renal damage more than propranolol (P < .05). In addition, the lower (1200 ppm) dose of carvedilol, which decreased neurobehavioral deficits and mortality, had no significant effects on organ mass or renal function, but significantly (P < .01) reduced renal damage. These data indicate that both beta adrenoceptor blockers, especially carvedilol to a considerably greater degree, convey significant protection in a genetic model of severe hypertension that results in renal and cardiovascular organ pathology, neurobehavioral deficits and premature death.

摘要

在易患中风的自发性高血压大鼠中,测定了新型血管舒张性β受体阻滞剂兼抗氧化剂卡维地洛和普萘洛尔对存活率、神经行为缺陷、心血管参数、血浆肾素、血浆醛固酮水平及肾脏病理的影响。让易患中风的自发性高血压大鼠饮用1%氯化钠溶液,并给予补充了卡维地洛(1200或2400 ppm)或普萘洛尔(2400 ppm)的高脂饮食。对照组由给予相同饮食但未补充药物的易患中风的自发性高血压大鼠组成。喂食普萘洛尔的动物血液水平为864±68 ng/ml,而喂食卡维地洛的动物在1200 ppm时血液水平为24±4 ng/ml,在2400 ppm时为471±145 ng/ml。卡维地洛和普萘洛尔治疗导致显著的β肾上腺素能受体阻滞。两种化合物均降低心率,但对收缩期动脉血压无显著影响。接受卡维地洛和普萘洛尔治疗的动物在预防神经行为缺陷和死亡率方面也表现出显著且持久的保护作用(P<.01)。普萘洛尔可显著降低未治疗对照组中升高的血浆肾素活性和醛固酮水平(P<.05),相同剂量的卡维地洛降低程度更大(P<.01)。与普萘洛尔(同等剂量)相比,卡维地洛在更大程度上降低了肾脏组织病理学损伤和心脏肥大(P<.01)。在治疗18周时,接受卡维地洛(P<.01)和普萘洛尔(P<.01)治疗的动物肾脏损伤均显著减轻。卡维地洛比普萘洛尔更能减轻肾脏损伤(P<.05)。此外,较低剂量(1200 ppm)的卡维地洛虽能减少神经行为缺陷和死亡率,但对器官重量或肾功能无显著影响,却能显著(P<.01)减轻肾脏损伤。这些数据表明,两种β肾上腺素能受体阻滞剂,尤其是卡维地洛,在导致肾脏和心血管器官病理、神经行为缺陷及过早死亡的严重高血压遗传模型中具有显著的保护作用,且卡维地洛的保护作用程度更大。

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