切除犬第3脂肪垫对Bezold-Jarisch反射的影响  

Excising SVC-AO fat pads attenuates Bezold-Jarisch reflex in dogs

作　　者：夏阳[1] 杨志健[2] 张家友[2] 赵亮[2] 顾兴建[2] 廖德宁[2] 

机构地区：[1]解放军第101医院心内科,江苏无锡214044 [2]上海长征医院心内科,上海200003

出　　处：《医学研究生学报》2009年第9期908-911,共4页Journal of Medical Postgraduates

基　　金：国家自然科学基金资助项目(批准号:30570761)

摘　　要：目的:Bezold-Jarisch反射(BJR)是血管迷走性晕厥(VVS)最主要的发病机制之一,阻断迷走神经心脏传出支可能消弱BJR。观察切除犬第3脂肪垫(SVC-AO FP)对BJR及相关血流动力学指标的影响。方法:30只杂种犬麻醉后经右侧开胸,随机分为对照组和干预组(切除SVC-AO FP)。经左心室导管弹丸式推注藜芦定15μg/kg诱发BJR,比较2组推药前后HR、动脉压、左心室压、左心室压最大上升及下降速率(±dp/dtmax)的变化。结果:推注藜芦定前2组的各项指标无显著差异(P>0.05),推注藜芦定后干预组的HR的下降值显著低于对照组[(25.2±9.1)次/minvs(93.3±18.4)次/min,P<0.01],但2组动脉压、左心室压及±dp/dtmax变化比较差异无显著性意义(P>0.05)。结论:切除犬SVC-AO FP能明显消弱藜芦定诱发的BJR的HR下降,但不能消弱BJR引起的动脉压、左心室压、左心室收缩及舒张功能的下降。Objective ： The Bezold-Jarisch reflex （ BJR） is one of the main causes for vasovagal syncope （VVS）. Blocking the efferent pathways of the vagus ganglia in the heart may attenuate the B JR. Our study aimed to observe the effect excising the third fat pad （SVC-AO FP） during the veratridine-induced B JR in dogs. Methods： Right thoracotomy was performed in 30 mongrel dogs to access the chest cavities. The animals were divided into a control group and an intervention group, and the latter underwent excision of the superior vena cava - aortic fat pad （SVC-AO FP）. Veratridine was injected into the left ventricle in bolus doses of 15μg/kg through a catheter to induce BJR. The heart rate （HR）, systolic arterial pressure （SAP）, diastolic arterial pressure （DAP）, mean arterial pressure （MAP）, left ventricle systolic pressure （ LVSP）, left ventricle diastolic pressure （LVDP） and left ventricular peak systolic and diastolic velocity （ ± dp/dtmax ） were measured before and after veratridine injection. Results ： There were no significant differences in the baseline values of HR, SAP, DAP, MAP, LVSP, LVEDP and ＋ dp/dtmax between the two groups （P 〉 0.05） before veratridine injection. The maximum decrement of HR was significantly lower in the intervention group than in the control （25.2±9. 1bpm vs 93.3±18.4 bpm, P 〈0. 01 ） after veratridine injection, but the maximum decrement of SAP, DAP, MAP, LVSP, LV- EDP, ＋ dp/dtmax and -dp/dtmax showed no significant differences between both groups （P 〉 0. 05）. Conclusion ： Excision of the SVC-AO FP could significantly reduce bradycardia in veratridine-induced BJR.

关 键 词：射频消融 心脏脂肪垫 迷走神经节 BEZOLD-JARISCH反射 

分 类 号：R749.7[医药卫生—神经病学与精神病学]