左旋卡尼汀对犬心房急性缺血诱发电生理变化的影响  

Effects of L-carnitine on electrophysiological changes induced by atrial ischemia in dogs

作　　者：王玉堂[1] 闫俊瑾[2] 单兆亮[1] 周俊彦[1] 时向民[1] 国建萍[1] 

机构地区：[1]解放军总医院心内科,北京100853 [2]北京朝阳医院京西院区心脏中心,北京100043

出　　处：《中国实用内科杂志：临床前沿版》2006年第4期609-611,共3页

基　　金：全军医药卫生"十五"计划科研基金资助项目(01MB074)

摘　　要：目的观察左旋卡尼汀(L-CN)对犬心房急性缺血时心房肌电生理改变及心房颤动(房颤)诱发率的影响。方法2003～2005年将解放军总医院的12只健康杂种犬随机分为L-CN用药组和生理盐水对照组。结扎右冠状动脉心房分支,造成心房肌局部缺血。观察各组缺血前后右心房不同部位的有效不应期(AERP)、右心房内传导速度(CV)的变化,计算右心房内心房激动波波长(WL)和房颤的诱发率并行心房肌病理学检查。结果(1)结扎右冠脉后盐水组缺血区心肌AERP均明显缩短;L-CN组右冠脉结扎后AERP无显著缩短。(2)冠脉结扎前后,两组右心房内CV均无明显改变。(3)结扎冠脉后,盐水组右心房内WL明显缩短;L-CN组的WL无显著变化。(4)盐水组结扎右冠脉后在不同时间段测量时均诱发房颤,L-CN组结扎冠脉后均未诱发房颤。(5)盐水组可见不同程度的心肌缺血,以冠脉结扎处近端为显著;L-CN组不同部位心肌均未见缺血变化。结论L-CN能够有效防止心肌缺血诱发的电生理变化,从而有效减少房颤的发作。Objective To investigate the effects of L- carnitine （L- CN） on electrophysiological changes induced by atrial ischemia in dogs, Methods Twelve dogs were divided into normal saline （NS） group and L - CN group. Atrial ischemia was induced by ligation of an atrial arterial branch of right coronary artery. Atrial effective refractory period （AERP） and conduction velocity （CV） of right atrium were measured before and after 3 hour＇s coronary artery ligation. Atrial wavelength （WL） and inducibility of atrial fibrillation （AF） were calculated. Histological examination was performed. Results （1） AERP and WL shortened dramatically after ligation of coronary artery in NS group; they showed no remarkable change in L- CN group, （2） There was no significant change of CV in the two groups, （3） AF was induced in 0 of 12 dogs under basic condition. （3） After ligation of the right coronary artery, AF was induced in all of the 6 dogs in NS group and 0 of 6 dogs in L - CN group, （5） Histological examination revealed that the ischemic changes occurred only in NS group. Conclusion Electrophysiological changes induced by atrial ischemia could be prevented by infusion of L - CN.

关 键 词：心房 心肌缺血 电生理变化 左旋卡尼汀 犬 

分 类 号：R5[医药卫生—内科学]