肝内胆汁淤积症孕鼠的胎鼠心率功率谱变化与猝死的关系  

Change of Heart Rate Power Spectrum and Its Association with Sudden Death in the Fetuses of Rats with Intrahepatic Cholestasis of Pregnancy

作　　者：邵勇[1] 姚珍薇[1] 陆杰[2] 李红霞[1] 吴味辛[1] 丁敏[3] 

机构地区：[1]重庆医科大学附属第一医院妇产科,重庆400016 [2]重庆医科大学生理教研室,重庆400016 [3]重庆医科大学医学检验系,重庆400016

出　　处：《生物医学工程学杂志》2007年第6期1215-1219,共5页Journal of Biomedical Engineering

基　　金：国家自然科学基金资助项目(20475069);重庆医科大学优秀博士课题基金资助

摘　　要：应用皮下注射雌、孕激素建立妊娠肝内胆汁淤积(ICP)大鼠模型,通过Powerlab生物信号处理系统Chart5软件引导妊娠第21d胎鼠宫内心电图,分析胎鼠心率变异性(HRV)频域指标低频带(LF)、高频带(HF)及LF/HF值,探讨肝内胆汁淤积症孕鼠的胎鼠心脏自主神经系统变化与猝死的关系。结果显示,(1)ICP模型组孕鼠血清总胆汁酸水平为(78.5±4.5)μmol/L,正常对照组为(24.6±3.6)μmol/L,两组差异有极显著性;P<0.01;(2)ICP模型组实验开始时胎鼠心电图显示正常,持续观察29.3±6.4min后出现胎鼠心律不齐,继续观察23.5±4.6min后胎鼠死亡,而正常对照组持续观察90min,胎鼠心电图均显示正常;(3)ICP模型组胎鼠出现心律失常前20min内HRV频域指标LF和LF/HF分别为48.45±4.11nu和0.99±0.14,高于正常对照组胎鼠33.87±4.31nu和0.61±0.10,两组差异均有显著性,均为P<0.01;(4)ICP模型组胎鼠猝死前15min内LF及LF/HF随着死亡时间的濒临而呈进行性上升趋势。研究表明,孕鼠肝内胆汁淤积症时胎鼠死亡前出现短暂的心律失常阶段;ICP孕鼠的胎鼠猝死可能与高水平胆汁酸诱导胎鼠心脏自主神经活动失衡有关;HRV分析技术对于胎儿宫内安危的监护将会有很好的应用前景。To investigate the relationship between imbalance of cardiac autonomic nervous system and sudden death in fetuses of rats with intrahepatic cholestasis of pregnancy （ICP）, the animal model of ICP was induced by hypodermic injection of 17-α-ethinylestradiol and progesterone. The electrocardiograms and frequency domain analysis of heart rate variability （HRV） including low frequency （LF）, high frequency （HF） and the ratio between low and high frequencies （LF/HF） of fetal rats by the 21 st day of gestation were evaluated with Chart 5 software of Powerlab biologic signal extracting and analyzing system. Results： （1）The serum total bile acids （TBA） levels of pregnant rats were （78.5±4.5）μmol/L in Group ICP and （24.6±3.6）μmol/L in Group controls significant difference was noted between the two groups （P〈0. 01）. （2）In Group ICP, fetal rats arrhythmias appeared after （29.3±6.4）minutes＇ observation, and fetal rats died suddenly after （23.5±4.6）minutes＇ arrhythmias ± However, the fetal rats in Group control all showed normal electrocardiograms over 90 minutes＇ continuous observation. （3） The values of LF and LF/HF of fetal rats in Group ICP within 20 minutes before fetal rats arrhythmias were significantly higher than those in Group control （LF 48.45±4.11 nu vs 33.87±4.31 nu, and LF/HF 0.99±0.14 vs 0. 61±0.10, respectively, P〈0.01）. （4）Dynamic power spectral analysis of HRV indicated that the values of LF and LF/HF of fetal rats in Group ICP increased progressively within 15 minutes before the sudden death of fetal rats. These demonstrated that autonomic imbalance in association with increased sympathetic activity has been strongly implicated in the pathophysiology of fetal arrhythmogenesis and sudden death in ICP. HRV analysis could be a useful tool for fetal surveillance,especially for ICP.

关 键 词：妊娠肝内胆汁淤积症 心率变异性 自主神经系统 心律失常 猝死 

分 类 号：R714.2[医药卫生—妇产科学]