养心颗粒对心肌梗死后心脏电激动动态不稳定性的影响  

Effect of Yangxin Granule on Dynamical Heterogeneity after Myocardial infarction

作　　者：李晶洁[1] 宋丽云[1] 岳乐[1] 宋涛[1] 

机构地区：[1]哈尔滨医科大学附属第一医院,黑龙江哈尔滨150001

出　　处：《中医药信息》2012年第4期70-73,共4页Information on Traditional Chinese Medicine

基　　金：黑龙江省教育厅课题资助(11531081)

摘　　要：目的:研究心肌梗死后(MI)心脏局部电活动异常及养心颗粒对其干预作用。方法:将21只犬随机分为假手术对照组、MI组与养心颗粒组,通过结扎冠状动脉前降支造成左心室前侧壁心肌梗死模型,养心颗粒组术后每天给予养心颗粒2.53g/kg。上述各组于术后4周进行电生理检查,将心外膜袜状"矩阵电极"轻柔套在心脏上,"矩阵电极"接多导电生理仪后,对各组犬进行程序电刺激,分别观察心室激动波震荡、用AUTO CAD绘图软件绘制波碎裂最明显处有效不应期(ERP)恢复曲线、计算ERP恢复曲线最大斜率,观察恢复曲线斜率与波碎裂、室颤之间的关系。结果:正常对照组:最先出现波碎裂的位置大致都在左室心尖处;MI组:最先出现波碎裂的位置大致都在梗死区周边处,最先出现波碎裂的时间明显提前,ERP恢复曲线正常组与MI组相比,后者更陡峭,最大斜率明显增大;养心颗粒组:ERP恢复曲线较MI组平缓,最大斜率有所减小。结论:正常心脏的心肌存在明显的组织固有异质性和电生理异质性,两者均可导致心肌细胞动作电位不应期的空间不均一性,是室颤等心律失常发生的基础。MI可加重这种固有异质性,养心颗粒通过抑制心肌梗死后心脏的这种异质性,可能是其降低心律失常发生率的机制之一。Objective ：The purpose of the present study was to correlate the effects of Yangxin granule with myo-cardial electrophysiologic stability. Methods：Randomly treated with ligating the left anterior descending coronary artery or sham- operation procedure,21 canines were divided into control group（n =7） ,MI group（n = 7 ）, MI ＋ Yangxin granule group（ n = 7 ） （ which was given Yangxin Granule 2.53 g/kg each day after operation）. The programmed ventrieular stimulation was performed for four weeks after infarction. The epieardium sock electrode array was pulled over the heart softly for global epicardial mapping and electrode array was connected with electrophysiology instrument. Observe ventricular actived wave collision and use the AUTO CAD mapping software to paint ERP restitution curve of wavebreak, which was the most obvious calculation of the max slope of ERP restitution curve and then we could find the relationship clearly among the slope of ERP restitution curve, wavebreak and ventricular fibrillation. Results：Control group： the first wavebreak was always found at the left ventricular apex, MI group： the position of the first wavebreak was moved to the myocardium near the infarction areas, and the time of the first wavebreak was in advance, and the ERP restitution curve of this group changed to steeper and the max slope Yangxin Granule group： the ERP restitution curve increased obviously in compared with control group. MI ＋ was slower and the max slope decreased obviously in this group than that in the MI group. Conclusion：There are obvious tissue inherit heterogeneity and electrophysiolo- gy heterogeneity in normal myocardium, both of which can lead to space heterogeneity of myocardium action potential refractory period. All of these are the basis of arrhythmia such as ventricular fibrillation. MI can in- crease the heterogeneity. Yangxin granule can decrease the degree of sympathetic remodeling which may be one for the mechanisms of anti - arrhythmia.

关 键 词：养心颗粒 心肌梗死 动态电不稳定性 电生理 

分 类 号：R259[医药卫生—中西医结合]