肾上腺素能刺激和胆碱能刺激在犬阵发性房颤中的作用  

Effects of beta-adrenergic and cholinergic stimulation on canine spontaneous atrial fibrillation

作　　者：郭勇[1] 郑强荪[2] 王洪涛[2] 

机构地区：[1]武警吉林总队医院心内科,长春130052 [2]第四军医大学唐都医院心内科,西安710038

出　　处：《武警医学》2008年第12期1085-1087,共3页Medical Journal of the Chinese People's Armed Police Force

基　　金：军队"十五"医药卫生科研基金资助项目(01MB126)

摘　　要：目的探讨β肾上腺素能和胆碱能刺激及其阻断药在阵发性房颤中的作用。方法20只犬麻醉开胸后,在不给予心房电刺激的情况下分别经股静脉静滴乙酰胆碱(ACh)、儿茶酚胺及儿茶酚胺+乙酰胆碱诱发房颤(AF)。结果异丙基肾上腺素(IPA)及肾上腺素(EPI)(1～100μmol/L)AF的诱发率分别29%(14只犬中4只诱发),17%(6只犬中1只诱发)。静滴阿托品可以阻止肾上腺素能诱导的AF发生。ACh在20只犬中均诱发了房颤事件,阈浓度为:(2.8±0.3)μmol/L。IPA(10μmol/L)可使ACh诱发房颤的阈浓度降至(0.4±0.1)μmol/L(P<0.05),并使AF的持续时间从(25±7)s增加至(233±60)s(P<0.05)。β受体阻断药普萘洛尔(1 mg/kg)不能阻断ACh诱发的AF,但可使ACh的诱发阈浓度从(2.8±0.3)μmol/L提高至(23.5±3.4)μmol/L(P<0.05)。结论肾上腺素能和胆碱能在房颤的发生中均起作用,胆碱能刺激在阵发性房颤的诱发中起主要作用,肾上腺素能张力的改变在胆碱能介导的房颤发生与维持中起调节作用。bjective We studied the effects of beta - adrenergic and cholinergic stimMation and blockade on spontaneous atrial fib- rillation （AF） in the intact dog heart. Methods Perfusion of catecholamines and acetylcholine （ACh）, as well as their combination, through the femoral vein was used to induce AF in 20 anesthetized open - chest dogs without electrical stimulation of atrium. Results Isoproterenol and adrenaline （ 1 to 100μmol/L） induced AF in 29% （4 of 14） and 17% （ 1 of 6） of dogs, respectively. Atropine （ 1 to 2 mg） prevented catecholamine - induced AF. Acetylcholine （2.8 ±0.3） /nnol/L induced AF in all dogs. Beta - blockade by propranolol （ 1 mg/kg） did not prevent ACh- induced AF, but increased the threshold ACh concentration for AF induction to （23.5 ± 3.4 ） μmol/L（ P 〈0.05）. Aeetylebohnc - induced AF was facilitated by isoprotereno]（ 10 μmol/L）, which decreased the threshold ACh concentration for AF induction to （0.4 ± 0.1 ） mol/L（ P 〈 0.05） and increased the AF duration. （from 25 ± 7 to 233 ± 60s） （ P 〈 0.05）. Conclusions Although both autonomic systems play a role in AF, chohnergic stimulation is likely the main factor for sponlaneous AF initiation in this animal model. Adrenergie tone modulates the initiation and maintenance of chohnergicaUy induced AF.

关 键 词：自主神经 肾上腺素能 胆碱能 阵发性房颤 

分 类 号：R541[医药卫生—心血管疾病]