药物干预迷走神经对犬快速起搏心房电重构影响的实验研究  

Impact of Vagal Block on Electrical Remodeling in Dogs with Atropine induced Rapid Atrial Pacing

作　　者：韩秀[1] 常栋[2] 叶宇[3] 

机构地区：[1]大连医科大学附属第一医院心血管检查科,辽宁大连116011 [2]大连医科大学附属第一医院心血管内科,辽宁大连116011 [3]大连医科大学附属第一医院药剂科,辽宁大连116011

出　　处：《中国医科大学学报》2013年第10期869-872,共4页Journal of China Medical University

基　　金：国家自然科学基金(81200136)

摘　　要：目的通过测量心房有效不应期(ERP),研究迷走神经与房颤导致的心房电生理功能改变的关系以及药物干预对心房电重构的影响。方法12只成年犬戊巴比妥钠麻醉后分离颈部迷走—交感神经干,给予美托洛尔和阿托品阻断交感神经效应,分别测量高位右心房、冠状静脉窦远端于应用阿托品前在基础状态下与迷走神经刺激下的ERP和房颤易感窗口(VW),以及应用阿托品后心房电重构前后基础状态下与迷走神经刺激下的ERP和VW。结果阿托品应用前,迷走神经刺激下的ERP较基础状态下明显缩短(P<0.05);阿托品应用后,心房电重构前后迷走神经刺激下的ERP较基础状态下的ERP均无明显变化(P>0.05)。阿托品应用前迷走神经刺激下易诱发房颤(P<0.05);阿托品应用后心房电重构前后无论基础状态下或迷走神经刺激下,均不能诱发房颤(VW≈0)。结论对迷走神经进行药物干预,可以使心房电重构导致的ERP缩短,降低房颤发生率。Objective To measure atrial effective refractory period （ERP）,so as to investigate the impact of vagal modulation on atrial electrical remodeling in dogs.Methods A total of 12 mongrel dogs were involved in this study.Under anesthesia,metoprolol and atropine was given to block vagal and sympathetic efects.The change of arial effective refractory period （ERP） and vulnerability window （VW） were measured before and after atrial electrical remodeling with/without vagal stimulation.Results Before atropine administration,ERP changed significantly during vagal stimulation （P〈 0.05）.After atropine administration,ERP did not changed significantly during vagal stimulation （P 〈 0.05）.Atrial fibrillation could be induced before atropine administration during vagal stimulation （P 〈 0.05）,but it could not be induced at baselineand vagal stimulation before or after atrial electrical remodeling after atropine administration （VW ≈ 0）.Conclusion Vagal modulation can effectively decrease ERP induced by atrial electrical remodeling,and reduce the susceptibility to atrial fibrillation mediated by vagal.

关 键 词：心房颤动 迷走神经 心房电重构 

分 类 号：R331.3[医药卫生—人体生理学]