交感神经对急性心肌梗塞后QT间期离散度的影响  

The Influence of Cardiac Sympathetic Nerve on QT Dispersion in Acute Myocardial Infarction

作　　者：周惠云[1] 兰曦[1] 梁一鸣[2] 

机构地区：[1]暨南大学医学院第三附属医院(珠海市人民医院)心内科,广东省519000 [2]暨南大学医学院解剖学教研室

出　　处：《中国循环杂志》2001年第2期147-149,共3页Chinese Circulation Journal

基　　金：珠海市科委重点科技基金资助项目(99-43-14)

摘　　要：目的：本研究采用动物实验方法，旨在探讨交感神经对急性心肌梗塞（ＡＭＩ）后ＱＴ间期离散度（ＱＴｄ）变化的影响。 方法：观察去心交感神经组（Ａ组）与保留心交感神经组（Ｂ组）新西兰兔在ＡＭＩ前后的ＱＴｄ，并行心内电生理检查诱发室性心动过速，对两组各指标进行比较，同时设置假手术组（Ｃ组）作为对照。 结果：Ｃ组在手术前后ＱＴｄ比较无显著性差异（Ｐ＞０．０５）；Ａ组会心交感神经前ＱＴｄ与Ｂ组比较无显著性差异（Ｐ＞０．０５）；Ａ组去心交感神经后ＱＴｄ较前明显减小有显著性差异（Ｐ＜０．０５）。在ＡＭＩ后Ｂ组ＱＴｄ大于Ａ组有非常显著性差异（Ｐ＜０．０１）；Ａ组ＡＭＩ前后ＱＴｄ虽有变化，但无显著性差异（Ｐ＞０．０５）；而Ｂ组ＡＭＩ后ＱＴｄ大于ＡＭＩ前有非常显著性差异（Ｐ＜０．００１）；Ｂ组室性心动过速诱发率高于Ａ组有显著性差异（Ｐ＜０．０５）。 结论：在ＡＭＩ的新西兰兔模型中，Ｂ组ＱＴｄ显著大于Ａ组，且更易诱发室性心动过速。提示交感神经活性增强在ＡＭＩ后ＱＴｄ变化及室性心律失常发生中起重要作用。Objective: To study the sympathetic influence on QT dispersion after acute myocardial infaretion (AMI) in experimental rabbits. Methods:QTd of group A (rabbits without cardiac sympathetic nerve) and group B (rabbits with retained cardiac sympathetic nerve) were measured before and after AMI, and electrophysiologic examination was made to induce ventricular tachycardia(VT). The gained indexes of the two groups were analyzed and compared with each other. Group C (shame operation) was served as control. Results:QTd of group C had no significant changes before and after operation p>0. 05. Before cardiac sympathetic nerve was excised,QTd of group A was well-matched with that of group B p>0. 05. After cardiac sympathetic nerve was excised,QTd of group A was significantly smaller than before p<0. 05. QTd of group A was significantly smaller than that of group B after AMI p<0. 01. In group A,QTd after AMI was greater than before, but the difference was not significant p> 0. 05 ; but in group B, QTd after AMI was significantly greater than before p< 0. 001. In addition , the induced VT rate in group B was significantly higher than in group A (58. 33% vs. 8. 33%,p<0. 05). Conclusion: In AMI models of rabbits, QTd in group with retained cardiac sympathetic nerve was significantly greater than QTd in group with excised cardiac sympathetic nerve. Ventricular tachycardias were more easily induced in the former group. It was suggested that the increased sympathetic activity plays an important role in the changes of QT dispersion and in the occurrence of ventricular arrhythmia in AMI.

关 键 词：交感神经系统 急性心肌梗塞 QT间期离散度 室性心动过速 

分 类 号：R542.22[医药卫生—心血管疾病]