心房颤动犬复杂碎裂心房电图的神经机制研究  

Neuromechanism of complex fractionated atrial electrogram in dog with atrial fibrillation

作　　者：高崇瀚[1] 汪飞[2] 张进[1] 李崇雁 李发琪 殷跃辉[1] 

机构地区：[1]重庆医科大学附属第二医院心内科,重庆400010 [2]重庆医科大学附属第一医院急诊科,重庆400016 [3]重庆市超声医学工程重点实验室,省部共建国家重点实验室培育基地,重庆400016

出　　处：《解放军医学杂志》2010年第11期1357-1360,共4页Medical Journal of Chinese People's Liberation Army

摘　　要：目的探讨心房自主神经在心房颤动时复杂碎裂心房电图(CFAE)产生中的作用。方法 12只健康成年杂种犬随机均分为异丙肾上腺素(Iso)组和乙酰胆碱(Ach)组,每组6只。麻醉后开胸,分别于两组犬心耳表面局部应用Iso溶液或Ach溶液,诱发心房颤动。经心外膜记录两组犬的心房电图,分别标记CFAE和非CFAE位点,测定CFAE和非CFAE位点心房组织的自主神经密度。结果 Iso组CFAE位点心房组织交感神经密度[(4.23±1.15)×103μm2/mm2]显著高于非CFAE位点[(0.33±0.13)×103μm2/mm2,P<0.001];Ach组CFAE位点心房组织副交感神经密度[(7.37±1.43)×103μm2/mm2]明显高于非CFAE位点[(0.53±0.14)×103μm2/mm2,P<0.001]。结论房颤时CFAE多位于心房自主神经密度较高的区域,自主神经可能是CFAE产生的重要机制。Objective To investigate the effect of the atrial autonomic nerve in the formation of complex fractionated atrial electrogram （CFAE）. Methods Twelve healthy mongrel dogs of either sex weighing 25 to 20kg were randomized into isoprenaline group （Iso, n=6） and acetylcholine chloride group （Ach, n=6）. All dogs were anesthetized with 30mg/kg of sodium pentobarbital administered intraperitoneally and maimained throughout the experiments with hourly doses of 50--100mg. All animals were tracheally intuhated and ventilated with a positive pressure respirator. A left thoracotomy in the 4th intercostal space and a pericardiotomy were performed to expose the atria. Atrial fibrillation （AF） was then induced by topical application of Iso or Ach to the atria. Alter the induction of AF, atrial electrogram through epicardium mapping was performed. The locations of CFAEs and non-CFAEs were labeled with 5-0 suture respectively. All animals were euthanized by intravenous injection of a lethal dose of sodium pentoharbital immediately after the surgical and electrophysiological procedure. Labeled atrial tissues were harvested and sectioned for immunohistochemistry. Nerve density of tissue samples was determined by immunohlstochemical staining and computer-assisted morphometric analysis system. Results Either sympathetic nerve density of CFAE sites in Iso group [（4. 23± 1. 15） × 10^3μm^2/mm^2 vs （0. 33±0. 13） × 10^3μm^2/mm^2, P〈0. 001] or parasympathetic nerve density of CFAE sites in Ach group [（7. 37±1. 43） × 10^3μm^2/mm^2 vs （0. 53±0. 14） × 10^3μm^2/mm^2, P〈0. 001] was significantly higher than that of non-CFAE sites in each group. Conclusion CFAE locates in the region with high sympathetic and parasympathetic nerve density in AF, which may be the autonomic basis for CFAE formation.

关 键 词：心房颤动 复杂碎裂心房电图 自主神经通路 

分 类 号：R541.75[医药卫生—心血管疾病]