迷走神经对心房颤动作用的实验研究  

The Role Played by Vagus Nerve on Atrial Fibrillation: A Experimental Research

作　　者：张景昌[1,2] 钟国强[1,2] 宋红星[1,2] 凌云[1,2] 熊日新[1,2] 

机构地区：[1]广西医科大学第三附属医院 [2]南宁市第二人民医院心内科,南宁市530031

出　　处：《广西医学》2014年第5期565-568,共4页Guangxi Medical Journal

基　　金：广西医药卫生科研课题(重200633)

摘　　要：目的探讨迷走神经对心房颤动的作用。方法成年健康杂种犬8只,分别按顺序完成3个实验:单纯迷走神经刺激(A组)、阿托品+迷走神经刺激(B组)、切除上腔静脉中部和主动脉根部(SVC-AO)脂肪垫+迷走神经刺激(C组),完成每个实验后约间隔30 min再开始下一个实验。分别于切除脂肪垫、静滴阿托品及迷走神经刺激前后测定有效不应期(采用基础刺激周长逆减程序刺激方法)及房颤诱发数据(采用程序刺激和猝发刺激方法)。结果迷走神经刺激前各组心房和肺静脉有效不应期、各部位心房颤动诱发率、心房颤动持续时间比较,差异均无统计学意义(P>0.05);迷走神经刺激后实验A组心房和肺静脉有效不应期均明显短于B组、C组(P<0.05),A组多数部位心房颤动诱发率明显高于B组、C组(P<0.05),A组心房颤动持续时间明显长于B组、C组(P<0.05);但刺激后B组、C组上述指标比较,差异均无统计学意义(P>0.05)。结论切除SVC-AO脂肪垫能阻断迷走神经张力增高所致心房和肺静脉的电重构,有效阻止心房颤动的发生与维持。Objective To investigate the effects of vagus nerve on atrial fibrillation （AF）.Methods Eight healthy adult mongrel dogs were subjected to three experiments .The dogs in group A were treated with vagus nerve stimulation ,in group B were treated with atropine administration and vagus nerve stimulation ,and in group C were treated with the removal of fat pad locating between the medial superior vena cava and aortic root （SVC-AO fat pad） plus vagus nerve stimulation. There was a 30-minute interval between two experiments .The effective refractory period （ ERP） and inductive incidence of AF were measured before and after SVC-AO fat pad removal ,intravenous drip of atropine as well as vagus nerve stimulation , respectively .Results Before vagus nerve stimulation , there were no significant differences in the atrial and pulmonary venous ERPs,inductive rate and duration of AF among three groups （P〉0.05）.After vagus nerves stimulation,the atrial and pulmonary venous ERPs in group A were significantly shorter than those in group B or group C （P〈0.05）,the inductive rates of AF at most sites in group A were significantly higher than those in group B or group C （P〈0.05）,and the duration of AF in group A was significantly longer than that in group B or group C （P〈0.05）.After vagus nerves stimulation ,there were no significant differences in the indexes above between group B and group C （P〉0 .05 ） .Conclusion SVC-AO fat pad removal can effectively prevent the atrial and pulmonary venous electrial remodeling caused by increased vagal tone as well as the development and maintenance of AF .

关 键 词：心房颤动 迷走神经 心脏脂肪垫 有效不应期 犬 

分 类 号：R331.38[医药卫生—人体生理学] R541.75[医药卫生—基础医学]