刺激左右颈部迷走交感干对兔心室电生理特性的影响  

The effects of electrical stimulating left and right cervical vagosympathetic trunk on electrophysiologic characteristics of right ventricle in rabbits.

作　　者：刘蔚[1] 高梅[2] 王奖荣[2] 孙慧[2] 贾晓蒙[2] 侯应龙[2] 

机构地区：[1]山东省千佛山医院超声科,山东济南250014 [2]山东省千佛山医院心内科,山东济南250014

出　　处：《中国心脏起搏与心电生理杂志》2009年第5期437-440,共4页Chinese Journal of Cardiac Pacing and Electrophysiology

摘　　要：目的探讨心脏外在自主神经对心室电生理特性的影响及其在室性心律失常发生中的可能作用。方法新西兰大白兔10只静脉麻醉,将6F电极导管通过右侧颈静脉经三尖瓣置入右室,并给予设定的电程序刺激,记录基础状态下心室有效不应期(VERP)、Q-T间期离散度(Q-Td)、Tpeak-Tend离散度(Tp-ed)、心室颤动阈值(VFT);再分离并暴露双侧颈部迷走交感干,分别给予左右单侧及双侧迷走交感干电刺激使心率较基础状态分别减慢10%、30%、50%,重复上述电刺激,并测量上述电生理指标。结果随着刺激颈迷走交感干强度的增加,与基础状态比较,VERP逐渐延长,至左右单侧刺激强度使心率减慢50%、双侧刺激减慢30%时,VERP延长有统计学意义(P<0.05);Q-Td随刺激强度的增加呈逐渐增大趋势,至左、右单侧刺激强度使心率减慢30%、双侧刺激减慢10%时,Q-Td增大具有统计学意义(P<0.05),随着刺激强度地增加,变化更显著(P<0.01);Tp-ed随刺激强度的增加呈逐渐增大趋势,至左、右单侧及双侧刺激强度使心率减慢30%时,Tp-ed增大有统计学意义(P<0.05);给予实验设定的不同强度的左、右单侧颈迷走交感干刺激,与基础状态比较VFT无明显变化,而同时给予双侧颈迷走交感干刺激时,VFT有逐渐减小趋势,但仍无统计学意义。结论心脏外在自主神经在心室电生理特性变化中亦起重要作用,可能是室性心律失常发生的潜在因素。Objective To investigate the electrophysiologie effects of extrinsic autonomic nervous on ventricle by stimulating rabbit cervical vagosympathetie trunk（CVST） in different electrical intensity. Methods Ten New Zealand rabbits were anesthetized. A electrical catheter was inserted into right cardiac ventricle through right jugular vein and atrioventricular valve. The ventrieal effective refractory period（VERP） , Q-T interval dispersion（Q-Td） , Tpeak-Tend dispersion（ Tped）, ventrical fibrillation threshold （VFT） were measured and recorded by means of programmed electrical stimulation （PES）. Then bilateral CVSTs were disassociated, exposed and stimulated by different intensity to reduce heart rate by 10% ,30% ,50% respectively. The same PES was performed and same indexes were recorded. Results Compared with the baseline, the prolongation of VERP was getting significant （ P 〈 0.05 ） when the intensity of stimulating left or right CVST was increased to reduce the heart rate（HR） by 50% ,or bilateral CVST reduce the HR by 30% ; a significant change in Q-Td was also observed （ P 〈 0.05 ） when the intensity of stimulating left or right CVST was increased to reduce the HR by 30% , or bilateral CVST reduce the HR by 10% ; As the stimulating intensity was getting stronger, more remarkable changes above were observed（ P 〈 0.01 ）. Tp-ed enlargement was getting significant （ P 〈 0.05 ） when the intensity of stim- ulating left, right or bilateral CVST was increased to reduce the heart rate （HR） by 30%. However, no significant change of ventricle fibrillation threshold （VFT） was observed during stimulating any CVST with any intensity, just a lowering trend showed as stimulating bilateral CVST. Conclusion Cardiac extrinsic autonomic nervous system plays an important role in changes of electrophysiologic characteristics of ventricle, which may be a latent factor of ventricular arrhythmia. [ Chinese Journal of Cardiac Pacing and Electrophysiology, 2009,23 （5） ：437 -440

关 键 词：心血管病学 颈迷走交感干 有效不应期 Q—T间期离散度 心室颤动阈值 

分 类 号：R331.38[医药卫生—人体生理学]