低强度神经节丛刺激对正常心室电生理性质和急性心肌缺血室性心律失常发生的影响VIP免费

·214·主堡!坚徨基堂堂盘盍垫!!生!旦筮!!鲞筮!塑g!也!垦!趟i婴尘些丝!，』!些垫!!：!塑：!!盟!：!·基础研究·低强度神经节丛刺激对正常心室电生理性质和急性心肌缺血室性心律失常发生的影响何勃何文博鲁志兵黄兵吴柳胡笑容崔博江洪【摘要】目的研究低强度神经节丛(GP)刺激对正常心室电生理性质和急性心肌缺血室性心律失常发生的影响。方法体重18～25蚝的正常成年杂种犬39只随机分为正常心脏组(n=12)和急性心肌缺血组(凡=27，其中对照组12只，低强度GP刺激组15只)，以2根多极电生理导管记录左、右心室局部电图，以自制Ag—AgCl电极记录左、右心室单相动作电位。在正常犬，分别在6h低强度GP刺激前和刺激后测量心室各部位有效不应期(ERP)、动作电位时限(APD)，APD回复性质和APD交替以及血清乙酰胆碱和去甲肾上腺素浓度；在急性心肌缺血犬，比较室性心律失常的发生情况。结果在正常犬，6h低强度GP刺激显著延长心室各部位ERP及APD(P<0．05)，但未改变其空间离散度；6h低强度GP刺激促进APD交替发生但不改变APD回复曲线斜率及其空间离散度；6h低强度GP刺激后血清去甲肾上腺素和乙酰胆碱水平均显著增加(P<0．05)。在急性心肌缺血犬，低强度GP刺激组室性心律失常的发生率显著低于对照组(P<0．05)。结论低强度GP刺激不增加正常心脏室性心律失常的风险且有助于抑制急性心肌缺血心脏室性心律失常的发生。【关键词】神经节丛；室性心律失常；急性心肌缺血Effectsoflow-intensityganglionatedplexistimulationonventricniarelectrophysiologicalpropertiesinnormalheartandacutemyocardialischemiaincanineHEBo，HEWen—bo，LUZhi—bing，HUANGBing，WULiu，HUXiao—rong，CUIBo，JIANG胁昭．DepartmentofCardiology，RenminHospitalofWuhanUniversi—ty，Wuhan430060，ChinaCorrespondingauthor：JIANGHong，Email：hongj0505@126．com【Abstract】ObjectiveToinvestigatetheeffectoflow-intensityganglionatedplexistimulation(GPS)onventricularelectrophysiologicalpropertyinnormalheartandacutemyocardialischemia(AMI)incanine．Meth-odsThiay-nineadultmongreldogswereassignedintothenormalheartgroup(n=12)andtheAMIgroup(n=27．12incontroland15inlow．intensityGPS)．Twomulti．electrodecathetersweresuturedtorecordelectrogramsat8epicardialsitesfromtheapextobaseinleftandrightventficularfreewalls．Acustom-madeAg-AgCIelec-trodewasusedtorecordmonophasicactionpotentialsfromtheepicardialsurfaceoftheleftandrightventricularfreewallsat6sites．Innormalheart，ventrieulareffectiverefractoryperiod(ERP)，actionpotentialduration(APD)，electricalahemans，dynamicAPDrestitutionandserumlevelsofnorepinephrineandacetylcholineweremeasuredatbaselineandafter6-hourlow-intensityGPSrthestrengthforlow-intensityGPSwassetatthevoltagelevelcausinga10％decreaseofsinusrate)．InAMIheart，low-intensityGPSWasperformed1hourbe-forecoronaryarteryligationandtheelectrocardiogramswerecontinuouslymonitoredfor1hourduringligationtorecordthejncidenceanddurationofventriculararrhythmias．ResniIsInthenormalheart．6-hourlOW-intensi·tyGPSsignificantlyprolongedventricularERPandAPD(allP