世界中医药

目的：探讨燧心胶囊对心力衰竭(HF)大鼠心肌纤维化的保护作用及对AMP活化蛋白激酶（AMPK），核转录因子红系2相关因子2（Nrf2）通路的影响。方法：采用腹腔注射阿霉素法制备大鼠HF模型，造模成功后，燧心胶囊低、中、高剂量组依次灌胃给予燧心胶囊（1.3 mg/kg、2.6 mg/kg、5.2 mg/kg），缬沙坦组灌胃给予缬沙坦（13.35 mg/kg），1次/d，假手术组和模型对照组给予等量生理盐水，连续8周后测定大鼠心功能，对大鼠心脏组织进行Masson染色，同时检测心脏组织中超氧化物歧化酶（ROS）、谷胱甘肽（GSH）、超氧化物歧化酶（SOD）、AMPK、Nrf2和血红素加氧酶-1（HO-1)水平。结果：对照组大鼠心肌未见显著肌纤维，模型组大鼠心肌细胞间出现大量的纤维组织，各燧心胶囊剂量组和缬沙坦组大鼠心肌细胞间伴有不同程度的纤维组织增生，较模型组明显减轻，其中缬沙坦组大鼠改善最为显著。与对照组比较，模型组大鼠左心室射血分数（LVEF）、左室缩短分数（LVFS）、GSH、SOD、AMPK、Nrf2和HO-1水平降低，左室收缩期末内径（LVSD）、左室舒张末内径（LVEDD）和ROS水平升高（P<0.05）；与模型组比较，各燧心胶囊组和缬沙坦组大鼠LVEF、LVFS、GSH、SOD、AMPK、Nrf2和HO-1水平升高LVSD、LVEDD和ROS水平降低，各燧心胶囊组大鼠各指标随燧心胶囊剂量增加而变化，但缬沙坦组作用最显著（P<0.05）。结论：燧心胶囊能抑制HF大鼠心肌纤维化，其机制可能与AMPK/Nrf2通路激活有关。

English Summary:

To investigate the protective effect of Suixin Capsules against myocardial fibrosis and the influence on 5'adenosine monophosphate-activated protein kinase(AMPK)/NF-E2-related factor 2(Nrf2) pathway in rats with heart failure(HF).Methods:Adriamycin(intraperitoneal injection) was used to induce HF in rats.Suixin Capsules(1.3 mg/kg，2.6 mg/kg，5.2 mg/kg) was given by gavage to rats in low-，medium-，and high-dose Suixin Capsules groups，respectively，and valsartan(13.35 mg/kg，i.g.，once a day) to rats in the valsartan group.The sham operation group and model group received the equivalent amount of normal saline.After 8 weeks，the cardiac function of rats was measured，and Masson staining of rat heart tissue was performed.The levels of reactive oxygen species(ROS)，glutathione(GSH)，superoxide dismutase(SOD)，AMPK，Nrf2，and heme oxygenase 1(HO-1) in the heart tissue were detected.Results:No obvious muscle fibers in the myocardium of the control group were observed，while a large amount of fibrous tissue between myocardial cells was found in the model group.Suixin capsules groups and the valsartan group showed different degrees of fibrous tissue proliferation in the myocardial cells，which was alleviated as compared with that in the model group，particularly in the valsartan group.The levels of left ventricular ejection fraction(LVEF)，left ventricular fractional shortening(LVFS)，GSH，SOD，AMPK，Nrf2，and HO-1 were lower and the levels of left ventricular systolic diameter(LVSD)，left ventricular end-diastolic diameter(LVEDD)，and ROS were higher in the model group than in the control group(P<0.05).Compared with the model group，Suixin Capsules groups and the valsartan group had higher levels of LVEF，LVFS，GSH，SOD，AMPK，Nrf2，and HO-1 and lower levels of LVSD，LVEDD，and ROS.The changes of the indexes were dose-dependent in the Suixin Capsules groups，but the effect of valsartan group was the most significant(P<0.05).Conclusion:Suixin Capsules inhibits myocardial fibrosis in HF rats by activating the AMPK/Nrf2 pathway.

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