胺碘酮或氯沙坦及两者合用对急性心房颤动患者心房重构的干预  

Effects of amiodarone plus losartan on atrial remodeling of acute atrial fibrillation

作　　者：魏立业[1] 夏岳[1] 戚国庆[1] 

机构地区：[1]河北医科大学第一医院心内科,石家庄050031

出　　处：《临床心血管病杂志》2008年第3期162-164,共3页Journal of Clinical Cardiology

基　　金：河北省卫生厅项目(No:05019)

摘　　要：目的:采用人工心脏起搏的方法制备家兔急性心房颤动模型,分别探讨胺碘酮与氯沙坦对心房颤动导致心房重构的不同干预效果。方法:40只家兔随机分为0.9%氯化钠溶液组(对照组)、胺碘酮组、氯沙坦组、合用组,分别灌胃给药1周,以600次/min的频率起搏心房8 h,并分别于起搏前、起搏后0.5、1、2、4、6、8 h及停止起搏后10、20、30 min重复测定心房有效不应期(AERP)。结果:①经过8 h快速起搏后对照组AERP200(100.63±7.5)ms和AERP150(95.01±6.2)ms均较起搏前明显缩短(均P<0.01),AERP200较AERP150缩短更为明显(P<0.05),胺碘酮组、氯沙坦组及合用组快速起搏前后AERP无显著变化。②停止快速起搏后,对照组AERP逐渐恢复,AERP200和AERP150在10 min内基本恢复至起搏前的95.78%和96.76%,30 min内基本恢复至起搏前的99.07%和99.39%。结论:短期快速心房起搏可致心房电重构;胺碘酮和氯沙坦可以逆转心房电重构。Objective： To investigate the electrical remodeling and the effects of amiodarone and losartan on electrical remodeling by rapid atrial pacing on rabbit model. Method ： Forty normal rabbits were randomly divided into 4 groups： the saline group（control group）, amiodarone group, losartan group, Amid-Los group. All rabbits were raised drugs in a week. The atrial effective refractory period （AERP） was measured. Then, take a rapid atrial pacing （600 bpm） and the AERP was measured after 0. 5,1,2,4,6 and 8 hours pacing and 30 minutes after the termination of rapid pacing. Result： ① In control group, after 8 hours rapid pacing AERP200 （100.63 ± 7.5）ms and AERP150 （95.01 ± 6.2） ms were significantly shortened （ P〈 0.01）. And the degree of AERP shortening induced by rapid pacing was greater at AERP200 than that at AERP150. The AERP of Amiodarone , Losartan group and Amid-Los group werer not shortened during rapid pacing. ②In the control group, after the termination of rapid pacing, the AERP gradually increased. The AERP at all of the examined recovered to almost the 95.78% and 96.76% of baseline values within the first 10 minutes and recovered to almost the 99.07% and 99.39% of baseline values within the first 30 minutes. Conclusion： Short term atrial rapid pacing can induce the atrial electrical remodeling. Amiodarone and Losartan can prevent the electrical remodeling.

关 键 词：心房颤动 心房重构 胺碘酮 氯沙坦 

分 类 号：R541.7[医药卫生—心血管疾病]