持续性快速右心房起搏犬肺静脉-左心房连接处自主神经重构的研究  

Autonomic neural remodeling of pulmonary vein-left atrium junction in a prolonged right atrial pacing canine model

作　　者：郑少华[1] 张玉娇[1] 李志远[2] 侯绪娟 王曦敏[1] 段文昌[4] 侯应龙[1] 

机构地区：[1]山东大学附属千佛山医院心内科,济南250014 [2]山东省泰山疗养院心内科,山东泰安271000 [3]山东省医学科学院,济南250012 [4]山东大学附属千佛山医院保健科,济南250014

出　　处：《山东大学学报（医学版）》2013年第12期7-10,33,共5页Journal of Shandong University:Health Sciences

基　　金：国家自然科学基金(81270237);山东省科技发展计划(2011GSF11837)

摘　　要：目的定量研究持续性快速右心房起搏后犬肺静脉-左心房(PV-LA)连接处自主神经重构的情况。方法12只健康成年杂种犬,随机分为对照组和起搏组,每组各6只,起搏组以400次/min的速率快速起搏犬右心房,持续4周。起搏结束后立即测定所有犬左上肺静脉-左心房(LSPV-LA)连接处的有效不应期,并收集所有PVLA连接处直径为1 cm内的组织。用酪氨酸羟化酶(TH)及乙酰胆碱转移酶(ChAT)分别标记交感与副交感神经,并通过免疫组化染色及Western blotting进行神经定量研究。结果起搏组LSPV-LA连接处有效不应期较对照组显著缩短[(83.33±16.33)vs(111.67±20.41)ms,P<0.05]。起搏组2只犬发生自发性房颤,而对照组无房颤发生。免疫组化染色显示,起搏组LSPV-LA连接处TH及ChAT的平均密度及分布不均一程度均显著高于对照组(P<0.01)。Western blotting显示,起搏组的4个PV-LA连接处TH和ChAT总表达量显著增加(P<0.01)。结论持续性快速右心房起搏后犬PV-LA连接处发生了自主神经重构,可能与房颤的发生相关,并在房颤的射频消融治疗中具有重要意义。Objective To quantificationally investigate the autonomic neural remodeling of pulmonary vein-left atrium （PV-LA） junction in a prolonged fight atrial pacing canine model. Methods A total of 12 healthy adult mongrel dogs, weighing 15-20 kg, were randomly divided into 2 groups： 6 （paced group） underwent rapid fight atrial pacing at 400 bpm for 4 weeks ; 6 （ control group） were not paced. The effective refractory period （ERP） of left superior pulmo- nary vein-left atrium （LSPV-LA） junction in all animals was measured and the experimental tissues were harvested from l cm around all PV-LA junctions immediately after 4 weeks of pacing. Expressions of tyrosine hydroxylase （TH） and choline acetyltransterase （ChAT） were detected with immunohistochemical staining and Western blotting. Results Compared with that of the control group, the ERP of LSPV-LA junction of the paced group was significantly shortened [ （83.33 ± 16.33 ） vs （ 111.67 ±20.41 ） ms, P 〈 0.05 ]. Spontaneous atrial fibrillation developed in 2 animals in the paced group, but not in the control group. Immunohistochemistry showed that the average density and heterogeneity of TH and ChAT at LSPV-LA junction in the paced group were significantly higher than those of the control group （P 〈 0.01 ）. Western blotting showed that the expressions of TH and ChAT at the 4 PV-LA junctions in the paced group increased markedly compared with those of the control group （ P 〈 0.01 ）. Conclusion Autonomic neural remodeling does exist in the PV-LA junction after prolonged atrial pacing, which may contribute to the initiation of atrial fibrillation. This may promote the management of atrial fibrillation by effectively guiding the radiofrequency catheter ablation procedure.

关 键 词：自主神经重构 肺静脉-左心房连接处 心房颤动 射频消融术 

分 类 号：R541.7[医药卫生—心血管疾病]