稳心颗粒对心房神经节消融后心房颤动的影响机制  

Impacts of WenxinKeli on atrial fibrillation inducilibity after epicardial ganglionic plexi ablation

作　　者：肖金平[1] 邓宏平[1] 王徐乐[1] 代子玄[1] 于胜波[1] 赵庆彦[1] 黄从新[1] 

机构地区：[1]武汉大学人民医院心内科,430060

出　　处：《中华心律失常学杂志》2013年第5期367-370,共4页Chinese Journal of Cardiac Arrhythmias

基　　金：国家自然科学基金（81070144）

摘　　要：目的 探讨口服稳心颗粒对犬心房神经节（GP）消融后心房颤动（房颤）诱发的影响.方法 19只犬随机分为假手术组、GP消融组和稳心颗粒组.所有犬左侧第4肋间开胸,右心房短阵快速起搏观察房颤诱发情况.假手术组电生理监测后关胸,GP消融组和稳心颗粒组开胸后消融心房左、右GP,所有犬喂养8周,其中稳心颗粒组给予稳心颗粒0.25g·kg-1 ·d-1.8周后再次观察房颤诱发和心房基质变化.结果 与假手术组和稳心颗粒组相比,GP消融组8周后房颤诱发率明显升高.GP消融组犬血浆脑钠钛（BNP）明显增高[（142.2±21.4）pg/ml对（259.3±34.5）pg/ml,P＜0.01],而稳心颗粒组的BNP水平在消融8周后降低,但差异无统计学意义；3组犬在开胸前和喂养8周后血肿瘤坏死因子（TNF-α）和白细胞介素6（IL-6）无明显变化；与假手术组相比,GP消融组8周后左右心房肌组织中的BNP,TNF-α和IL-6水平明显增加,左心房组织的BNP,TNF-α和IL-6水平分别为[（117.1±15.2） pg/mg对（121.3±14.9）pg/mg,P＞0.05; （91.3±35） pg/mg对（180.3±72） pg/mg,P=0.02; （125.3±42） pg/mg对（273.3±83）pg/mg,P＜0.01]；右心房组织的BNP,TNF-α和IL-6水平分别为[（143.6±33.7） pg/mg对（206.2±41.4） pg/mg,P=0.02;（75.3 12.1）pg/mg对（141.3±64） pg/mg,P=0.03;（175.1±42.5）pg/mg对（351.7±101）pg/mg,P＜0.01].假手术组和稳心颗粒组心房肌组织中的BNP,TNF-α和IL-6水平差异无统计学意义.结论 长期口服稳心颗粒可抑制心房GP消融后基质重构和房颤的诱发.Objective To investigate the effect of WenxinKeli on inducibility of atrial fibrillation（AF） after long-term ganglionic plexi（GP） ablation.Methods Nineteen dogs were randomly divided into sham-operated group,GP ablation group and Wenxin group.All animals underwent a left thoracotomy at the fourth intercostal space.AF inducibility was assessed by burst rapid pacing at right atrium （RA）.Both the GP ablation group and Wenxin group received four major GPs ablation.The Wenxin group was administrated oral WenxinKeli.All the animals were allowed to recover for 8 weeks,after which,AF was measured again.Results AF was induced easily in the GP ablation group than in the sham-operated group and Wenxin group after 8 weeks.Compared with the sham-operate group,the blood BNP was increased significantly 8 weeks after GP ablation [（142.2±21.4） pg/ml vs （259.3± 34.5）pg/ml,P〈0.01].Level of BNP decreased after GP ablation in Wenxin group,but with no statistical significance compared with baseline.The blood concentrations of TNF-α and IL-6 were not significantly different before thoracotomy and after 8 weeks in the three group dogs.When compared with that in the sham-operated group,levels of BNP,TNF-α and IL-6 in atrial were greatly increased in the GP group：levels of BNP,TNF-α and IL-6 in LA tissues[（117.1±15.2） pg/mg vs（121.3±14.9）pg/mg,P〉0.05; （91.3±35） pg/mg vs（180.3±72） pg/mg,P=0.02; （125.3±42） pg/mg vs（273.3±83） pg/mg,P〈0.01] ; Levels of BNP,TNF-α and IL-6 in RA tissues [（143.6±33.7） pg/mg vs（206.2±41.4） pg/mg,P=0.02 ; （75.3±12.1）pg/mg vs （141.3±64） pg/mg,P=0.03;（175.1 ±42.5）pg/mg vs （351.7± 101）pg/mg,P〈0.01].However,there was no significant difference in levels of BNP,TNF-α and IL-6 in atrial tissues between the shamoperated group and Wenxin group.Condusion Epicardial ablation of GPs can induce atrial substrate remodeling and these changes might be suppressed by long-term oral WenxinKeli.

关 键 词：心房颤动 神经节 消融 稳心颗粒 炎症 重构 

分 类 号：R259[医药卫生—中西医结合]