卡维地洛对家兔心肌梗死后心室肌跨壁离散度的影响  

Effect of carvedilol on transmural dispersion of repolarization in ventricular infarction zone of myocardial infarction rabbits

作　　者：雷靖祎[1] 

机构地区：[1]西安市中心医院心内科,西安710003

出　　处：《陕西医学杂志》2010年第4期390-392,共3页Shaanxi Medical Journal

摘　　要：目的:探讨口服卡维地洛对急性心肌梗死(AMI)后梗死区心室肌细胞的单相动作电位时限(MAPD)和有效不应期(ERP)及跨室壁复极离散度(TDR)和跨室壁不应期离散度(TDERP)变化的影响。方法:40只家兔随机分为单纯梗死组(n=20)和卡维地洛组(n=20)。两组动物开胸后结扎左冠状动脉前降支造成左心室前壁心肌梗死,卡维地洛组于手术当天开始口服卡维地洛(Carvedial,0.33mg/kg·d)。结合单相动作电位记录技术和程控电刺激技术,测定梗死前、梗死后10min、30min、1h、1d,在梗死区同一位点测定心内膜(Endo)、中层(Mid)、心外膜层(Epi)3层心肌MAPD90和ERP,并计算TDR和TDERP。结果:梗死前,卡维地洛组与单纯梗死组比较MAPD90、ERP、TDR、TDERP之间无显著差异。梗死后10min、30min、1h、1d,卡维地洛组3层心肌MAPD90,ERP与单纯梗死组比较均延长,以MAPDmid90延长最为显著,TDR,TDERP与单纯梗死组比较减小,差异有统计学意义(P<0.05)。结论:卡维地洛可减小梗死后心室肌TDR,TDERP增大程度,减少AMI后发生恶性室性心律失常。Objective：To investigate the effect of carvediol on the monophasic action potential and effective refractory period （ERP） and transmural dispersion of repolarization of ventricular infarction zone in rabbit models of myocardial infarction Methods： Forty rabbits randomized into infarction group and carvedilol group. Rabbits in carvedilol group start to carvediol（Carvedial,0.33mg/kg.d） with oral on the day .Anterior wall myocardial infarction was produced in infarction group and carvedial group by ligating the left anterior descending coronary artery. Employing the monophasic action potential recording technique and the programmed electrical stimulation technique, determine monophasic action potential duration （MAPD90） and effective refraction period （ERP）, as well as compute transmural dispersion of repolarization（TDR）and transmural dispersion of effecive refractory period（TDERP） in infraction zone in three layers before infraction and ten minutes after infraction, thirty minutes after infraction, one hour and one day after infraction.Results： In infarction group, MAPD90 and ERP of three layers of ventricular wall shortened markedly by 10 min and 30 min and 1 hour and 1 day after infraction, the MAPD mid90 which achieved about half of baseline by 10 min after infraction . MAPD90 and ERP gradually recovered by after infraction Conclusion： Carvedilol diminished increasing of TDR,TDERP after AMI,and diminished arrhythmic after AMI.

关 键 词：心肌梗塞/生理学 @卡维地洛 动作电位 动物 实验 兔 

分 类 号：R542.22[医药卫生—心血管疾病]