伊布利特逆转犬48小时房颤心房肌电重构作用研究  

Reversion of Ibutilide fumarate on electrical remodeling of atria in 48 hours atrial fibrillation canine model

作　　者：高峰[1] 张彦[1] 侯月梅[1] 于付生[2] 冯艳[2] 

机构地区：[1]宁德市医院心内科,福建省352100 [2]新疆医科大学第一附属医院心律失常研究室,福建省352100

出　　处：《中国心血管病研究》2012年第10期781-784,共4页Chinese Journal of Cardiovascular Research

基　　金：国家自然科学基金资助项目（项目编号：30760079）

摘　　要：目的探讨国产富马酸伊布利特逆转犬48h房颤心房肌电重构的作用。方法健康成年杂种犬20只，随机分为快速起搏组（Pacing组，10只）和假手术组（Sham组，10只）。Pacing组通过右侧股静脉置入起搏电极，600次／min频率起搏高右房（HRA）制备房颤模型。48h后终止起搏，在心电和血液动力学监测下，给予国产富马酸伊布利特0．001m·kg^-1·min^-1静脉推注，房颤转复或累计剂量达0．04mg／kg停止给药。观察给药前后HRA的有效不应期（ERP，BCL=300ms）、传导速度（CV）、折返波长（WL）、频率自适应性、房颤诱发率等心房肌电生理指标的变化。结果Pacing组在起搏停止后，8只犬恢复窦律，2只犬持续房颤，给予伊布利特后1min内房颤终止。起博48h后，Pacing组ERP、CV、WL较Sham组减少，频率自适应性较Sham组降低，房颤诱发率明显增加；而给药后均恢复到起博前及Sham组水平。结论国产富马酸伊布利特能够逆转犬高右房快速起搏48h的心房肌电重构，有预防阵发性房颤发生的作用。其电药理学作用机制为：延长房颤时的心房不应期、心房肌电传导的速度及折返波长，提高心房肌频率的自适应性。Objective To investigate the reversion effect of Ibutilide fumarate on electrical remodeling of atria in 48 hours atrial fibrillation canine model. Methods Twenty clinical healthy adult mongrel dogs were divided into 2 groups randomly-pacing group （n=10） and sham group （n=10）. For the pacing group： pacing electrodes was implanted into high right atria through right femoral vein with high-speed pacing at a rate of 600 bpm for 48 hours. For the sham group： pacing electrodes was implanted but there were no interventions. Under the monitoring of electrocardiogram and hemodynamic, the Ibutilide fumarate were intravenously injected （0.001 m·kg^-1·min^-1）, Ibutilide fumarate was repeatedly infused until AF terminated （0.01-0.02 mg/kg） or when a cumulative dose was reached （0.04 mg/kg）. The parameters reflecting the change of atrial electrophysiology properties were observed, including effective refractory period （ERP） of high right atria, conduction velocity （ CV ）, wave length （WL）, adaptation of ERP, inducibility of atrial fibrillation. Results 8 dogs in the pacing group had cardioversion sinus rhythm after pacing terminated. 2 dogs AF sustained, AF terminated after administration of Ibutilide fumarate in 1 minute. The ERP, CV, WLof the pacing group is less than that the sham group（after being administered with Ibutilide fumarate, the ERP, ERP, CV, WL recovered to the baseline. The adaptation of ERP of the pacing group is ess than t the Sham group, after being administered with Ibutilide, it recovered to almost the baseline. Conclusion Ibutilide fumarate has a positive effect on the retroconversion of atrial electrophysiological remodeling on 48 hour a- trial fibrillation canine model and on prevention of paroxysmal atrial fibrillation. The potential mechanism of electro-pharmacology maybe： the prolonged atrial effective refractory period, the prolonged electric conduction velocity of atria and reentry wave length and the increased adaptability of atria.

关 键 词：房颤 犬 伊布利特 电重构 

分 类 号：Q95-33[生物学—动物学] R541.75[医药卫生—心血管疾病]