抗心律失常肽对低钾低镁条件下伊布利特致尖端扭转性室性心动过速的影响  

The effect of AAP10 on the torsades de pointes induced by ibutilide under condition of hypopotassemia and hypomagnesemia

作　　者：阮磊[1] 张存泰[1] 李连东[1] 全小庆[1] 周青[1] 徐仁德[1] 倪明科[1] 吴晓芬[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院综合科,湖北武汉430030

出　　处：《中国心脏起搏与心电生理杂志》2011年第5期418-421,共4页Chinese Journal of Cardiac Pacing and Electrophysiology

基　　金：国家自然基金资助项目(项目编号:30770879;30973601)

摘　　要：目的探讨缝隙连接开放剂抗心律失常肽(AAP10)对低钾、低镁条件下伊布利特致尖端扭转性室性心动过速(TdP)及心肌电不稳定性的影响。方法 54只日本长耳大白兔随机制备成左室楔形心肌块模型,随机分为对照组、低钾低镁组、伊布利特组、低钾低镁伊布利特组和AAP10干预组。对照组灌流正常台氏液,低钾低镁组灌流低钾低镁台氏液,伊布利特组灌流浓度2mg/l的伊布利特,低钾低镁伊布利特组灌流溶有同浓度伊布利特的低钾低镁台氏液,AAP10组给予AAP10干预的条件后灌流溶有伊布利特的低钾低镁台氏液。比较各组早期后除极(EAD)、R on T室性早搏和TdP的发生情况,以及QT间期、T波顶点到终点距离(Tp-e)和Tp-e/QT的变化。结果与对照组比较,低钾低镁伊布利特组QT间期、Tp-e和Tp-e/QT延长,EAD、R on T室性早搏、TdP的发生率明显增多。AAP10干预组,TdP、QT间期、Tp-e和Tp-e/QT比低钾、低镁伊布利特组显著减少。结论 AAP10可能通过开放缝隙连接减少跨壁复极离散度,从而起到预防伊布利特在低钾、低镁条件下的致TdP的作用。Objective To study the gap junction opener antiarrhythmic peptide 10（AAP10） on the torsades de pointes （TdP） induced by ibutilide under the condition of hypopotassemia and hypomagnesemia. Method Japanese long-eared white rabbits were divided into control group, hypopotassemia and hypomagnesemia group, ibutilide group, ibutilde and hypopotassemia and hypomagnesemia group and AAP10 group. In control group, left ventricular wedge were perfused with Tyrode＇s solution; in hypopotassemia and hypomagnesemia group, perfused with hypopotassemia and hypomagnesemia Tyrode＇ s solution; in ibutilde group, perfused with 2mg/L ibutilde; in the ibutilde and hypopotassemia and hypomagnesemia group, 2mg/L ibutilde was perfused under the conditon of hypopotassemia and hypomagnesemia; in AAP10 group, 500 nmol/L AAP10 was added into ibutilide under the condition of hypopotassemia and hypomagnesemia. The early after depolarization （EAD）, R on T extrasystole, TdP and the changed of QT interval, T wave peak to T wave end （Tp-e） and Tp- e/QT were observed. Result Compared with control group, the incidence of EAD, R on T extrasystole, TdP increased and the QT interval, Tp-e and Tp-e/QT prolonged in the ibutilide and hypopotassemia and hypomagnesemia group. In AAP10 group, the incidence of TdP decreased and the QT interval, Tp-e and Tp-e/QT were shorter while compared with ibutilide and hypopotassemia and hypomagnesemia group. Conclusion The TdP induced by ibutilde under the conditon of hypopotassemia and hypomagnesemia can be prevented by AAP10.

关 键 词：心血管病学 室性心律失常 尖端扭转性室性心动过速 伊布利特 缝隙连接 

分 类 号：R541.72[医药卫生—心血管疾病] R972.2[医药卫生—内科学]