胺碘酮对电击诱发心室颤动和除颤阈值的影响  

Effects of amiodarone on ventricular fibrillation vulnerability and defibrillation threshold induced by monophasic and biphasic shocks

作　　者：李翠兰[1,2] 胡大一[1,2] 

机构地区：[1]北京红十字朝阳医院心脏中心 [2]美国乔治城大学医学中心心脏科

出　　处：《中华心血管病杂志》1999年第3期228-230,共3页Chinese Journal of Cardiology

摘　　要：目的研究胺碘酮对单、双相电击的易损窗、易损上、下限以及除颤阈值（ＤＦＴ）的影响。方法在离体Ｌａｎｇｅｎｄｏｒｆ灌流兔心脏上记录单相动作电位以测量激活时间、动作电位时程（ＡＰＤ９０）、９０％复极恢复时间及其离散度。结果与对照组相比，胺碘酮延长ＡＰＤ９０和９０％复极时间（Ｐ＜００５），但并不改变激活时间离散度和９０％复极时间离散度；使单、双相电击的易损窗都显著右移（Ｐ＜００１），但对易损窗的宽度无影响；对单相电击的易损下限无影响，但显著抬高双相电击的易损下限；对易损上限和ＤＦＴ无影响。结论胺碘酮将单、双相电击的易损窗都右移并提高双相电击的易损下限，但在该模型中对两种电击的易损上限、ＤＦＴ和易损窗宽度均无直接影响。Objective To study the effect of amiodarone on vulnerable window (VW), upper (ULV) and lower limit of vulnerability (LLV), and defibrillation threshold (DFT) by monophasic (Mo) and biphasic (Bi) shocks Methods In isolated Langendorffperfused rabbit hearts (n=21) monophasic action potentials (MAP) were measured to determine activation time (AT), action potential duration (APD90), recovery time at 90% repolarization (RT90), and dispersion of RT90 during baseline (BL) and amiodarone (Amio) treatment Results Amio as compared to BL caused the following effects: (1) Prolongation of APD90 and RT90 (P<005) , no change of AT and RT90 dispersion (P=NS) (2) Rightward shift of the VW (P<001) but no change of the width of VW (P=NS) for Mo and Bi shocks (3) No change of the ULV and DFT (4) No change of the LLV for Mo shocks, but an increase for Bi shocks (P<005) Conclusion For Mo and Bi shocks, Amio shifts the VW to the right In addition, Amio increased the LLV for Bi shocks However, the ULV, DFT,and width of the VW are not affected by Amio for both shock waveforms in this model

关 键 词：胺碘酮 电生理学 动作电位 心室颤动 

分 类 号：R541.75[医药卫生—心血管疾病] R972.2[医药卫生—内科学]