体外冲击波对心脏电生理的影响  

Effects of extracorporeal shock wave on canine cardioelectrophsiology Study of effects of ESW on canine hemodynamic

作　　者：张小勇[1] 徐卫平[1] 邱汉婴[2] 

机构地区：[1]广东省清远市人民医院心内科,广东清远511500 [2]广东省汕头大学医学院附二院心内科,广东汕头515041

出　　处：《医学信息（中旬刊）》2010年第8期2089-2091,共3页Medical Information Operations Sciences Fascicule

摘　　要：目的:探讨体外冲击波(ESW)对犬心脏电生理的影响及其诱发心律失常的特点和机理。方法:以杂种犬的右心房、房室交界区、右室心尖部作为ESW的靶点,分别测定ESW冲击犬心脏各靶点前、后心脏电生理参数,并记录ESW冲击犬心脏前、后各4小时及冲击心脏过程中心律失常的类型及其数量。结果:ESW冲击犬心脏各靶点后,窦房结恢复时间及校正窦房结恢复时间明显延长(P<0.05),心肌有效不应期、舒张期阈值等参数无明显变化(P>0.05);ESW诱发早搏的特点:(1)来源于靶点区的早搏明显多于非靶点区的早搏;(2)ESW冲击心脏过程中前半程的早搏明显多于后半程的早搏;(3)落在体表心电图T-P段的ESW易诱发室性早搏,而落在T波降支的ESW则易诱发房性早搏或交界性早搏。结论:早搏由ESW直接诱发,并有适应现象;早搏的机制可能与ESW导致心肌牵张有关。Objective：To study effects of extracorporeal shock wave（ESW） on canine cardioelectrophysiology and to study mechanisms and characteristics of arrhythmia induced by ESW.Materials：ESW were discharged respectively at the right atrium,atrioventricle junction area and apex of the right ventricle.cardioelectrophsi-ological parameters were determined after and before discharges of ESW,Categories and their counts of arrhythmias were recorded for 1 hours before and after discharges of ESW and in the course of discharges of ESW.Results：After discharges of ESW,sinoatrial node recovery time（SNRT） and corrected sinoatrial node recovery time（SNRTc） were obviously delayed（P 0.05）.Effective refractory period（ERP）,diastolic threshold of atrium and ventricle and other parameters remained unchanged（P 0.05）.There were following characters in premature beats induced by ESW in the course of discharges：There were more premature beats originated from the targets of ESW than that from the non-target.There were more premature beats during the first half procedure than the second.when discharges of ESW on the T-P segment of ECG,ventricular premature beats were induced easy;atrial and atrioventriclar premature beats were easy induced when discharges of ESW on descent phase of T wave.Conclusions：Premature beats were only due to ESW itself and their mechanisms may be related to myocardial stretch,and canine hearts were adapted to ESW induceing premature beats.

关 键 词：体外冲击波 心律失常 窦房结恢复时间 有效不应期 阈值 

分 类 号：R331.38[医药卫生—人体生理学]