糖尿病家兔的心室电重构与心律失常的关系  

Relationship of electrophysiological remodeling and arrhythmias in ventricular of diabetic rabbits in vivo

作　　者：张中亚 於席芳 刘鲜梅 贾晓凤 李文星[2] 杨峥[2] 汪晶晶[2] 吴成云[2] 李庚山[2] 

机构地区：[1]黄石市一医院心内科,湖北黄石435000 [2]武汉大学人民医院心内科实验室

出　　处：《临床心血管病杂志》2013年第6期475-478,共4页Journal of Clinical Cardiology

摘　　要：目的:观察糖尿病家兔心电图和动作电位的主要电生理特征性变化,探讨糖尿病家兔心室电重构与室性心律失常的关系。方法:通过四氧嘧啶诱导建立糖尿病家兔模型,利用记录心电图和在体单相动作电位方法观察在体家兔主要心脏电生理参数改变以及程控和爆发式(Burst-pacing)刺激诱发有效不应期(ERP)和心律失常情况。结果:和对照组相比,糖尿病组心率明显减慢,QT间期显著延长,ST段显著上抬,T波增高(均P<0.05);动作电位明显增宽,时程延长,复极化恢复到10%、20%和50%时程(APD10、APD20和APD50)均显著延长,上升速率减慢(均P<0.05)。对照组ERP为(105.21±9.78)ms,糖尿病组为(168.95±10.03)ms(P<0.05)。Burst-pacing刺激诱导室性心律失常的发生率为87.5%(7/8)(P<0.01)。结论:糖尿病心肌病引起了明显的心肌细胞电重构,具有潜在触发性室性心律失常危险。Objective：To investigate the relationship of electrophysiological remodeling and arrhythmias via observing the alterations of QT interval and action potential duration（APD）in ventricular of diabetic rabbits in vivo.Method：Diabetes was induced by a single injection of alloxan（145mg/kg,i.v.）in rabbits.After the devel- opment of diabetes（10weeks）,the main electrophysiological parameters and ventricular effective refractory period （ERP）as well as arrhythmias induced by program and burst-pacing electrical stimulation protocols were perfo- romed using ECG measurements and monophasic action potential recording in healthy and diabetic rabbits.Result： Compared with control group,heart rate was significantly retarded and QT interval was lengthened（all P〈0.05） in diabetic group.Moreover,ST segment was remarkedly altered upward and T amplitude was increased（all P 0.05）in diabetic group.The phases of AP of ventricular myocytes in diabetic rats were obviously wider than that in control rats.Compared with control group,the duration of AP at 10%,20%,and 50%level of repolarization （APD10,APD20and APD50）were significantly elongated in diabetic group（all P〈0.05）.ERP was also obviously prolongated from （105.21±9.78）ms in control group to（168.95±10.03）ms in diabetic group（P〈0.05）.Ven- tricular arrhythmias and/or fibrillation evens were markedly induced with occurrence of 87.5% by burst-pacing. Conclusion：The diabetic cardiomyopathys are significant vulnerabilities to ventricular arrhythmias,which is attrib- uted to severely electrophysiological remodeling in diabetic nullitus.

关 键 词：心律失常 心室电重构 糖尿病 

分 类 号：R541.7[医药卫生—心血管疾病]