异氟醚、七氟醚对心肌单相动作电位的作用  

The effects of isoflurane and sevoflurane on monophasic action potential of myocardium

作　　者：谷宇[1,2] 高鸿[1] 杨烨[1] 

机构地区：[1]贵阳医学院附属医院麻醉科,550004 [2]湖北省襄阳市中心医院麻醉科

出　　处：《临床麻醉学杂志》2012年第10期1013-1016,共4页Journal of Clinical Anesthesiology

摘　　要：目的在兔离体心脏模型上研究异氟醚、七氟醚对心肌单相动作电位(MAPs)的作用。方法健康家兔56只,离体Langendorff灌注,随机均分为七组:0.65肺泡最小有效浓度(MAC)异氟醚组(A组),0.65MAC异氟醚+庚醇组(B组),1.3MAC异氟醚组(C组),0.65MAC七氟醚组(D组),0.65MAC七氟醚+庚醇组(E组),1.3MAC七氟醚组(F组),庚醇组(G组)。观察记录平衡灌注期间(T0)和继续灌注期(T1)的HR、心内膜心肌、中层心肌、心外膜心肌的单相动作电位时程(MAPD100)和振幅(MAPA)。结果 T1时B、E、G组HR明显减慢于T0时,T1时B组HR明显慢于A、C、D、E、F、G组,E组HR明显慢于D、F组(P<0.01);T1时心内膜心肌、中层心肌、心外膜心肌部位的B组MAPD100、MAPA明显短于T0时和其它各组(P<0.01);T1时C、E、G组心内膜心肌、中层心肌、心外膜心肌部位的MAPD100明显长于T0时和A、B、D、F组(P<0.01或P<0.05),E组心内膜心肌、中层心肌、心外膜心肌部位的MAPD100明显长于D、F组(P<0.01)。B组给药后有心律失常甚至心电活动停止现象。结论异氟醚延长MAPD100,可能与庚醇相似,异氟醚也通过阻滞缝隙连接,对心肌单相动作电位产生作用。七氟醚对心肌单相动作电位可能无明显影响。Objective To study the effects of isoflurane and sevoflurane on monophasic action potentials（MAPs） of three-layer myocardium in isolated rabbit hearts. Methods The hearts of fifty- six rabbits were perfused by modified krebs-hensleit buffer with I.angendorff device. All of the rabbits were randomly divided into seven groups （n=8）;0.65 MAC isoflurane group（group A）, 0.65 MAC isoflurane 4-enanthoi group（group B）, 1.3 MAC isoflurane group（group C）, 0.65 MAC sevoflurane group（group D）, 0.65 MAC sevoflurane ＋ enanthol group（group E）, 1.3 MAC sevoflurane group （group F） and enanthol group （group C-）. HR, MAP including time course（MAPDT00） and MAP amplitude of endocardium, mid layer myocardium and epicardium was recorded at the time of equation perfusion （baseline, T0） and drug treatment for 15 minutes（T1 ）. Results Compared with To, I-tR in groups B, g and G was significantly slower at T1. At T1, HR in group B was slower than those in group A, C, D, E, F and G while HR in group E was slower than that in group D and F（P〈0. 01）. ]n group B, MAPD100 in three sites at T1 was shortened compared with To, and was also shorter than that in other groups （P〈0.01）. In groups C, E and G, the MAPDl00 was lengthened at TI and was longer than those in groups A, B, D and F（P〈0. 01 or P〈0.05）. Group E showed even longer MAPD100 than groups D and F（P〈0. 01）. Arrhythmia or even electricity activity stop occurred after administration in group B. Conclusion Isoflurane lengthened the time course of MAPs. Similar to heptanol, isoflurane may affect the MAPs of myocardium through block gap junction. Sevoflurane may have no obviously effect on MAPs of myocardium.

关 键 词：异氟醚 七氟醚 庚醇 单相动作电位 缝隙连接 

分 类 号：R614[医药卫生—麻醉学]