尼可地尔在慢性缺氧诱导右心室肥厚及心房纤颤中的作用研究  

Nicorandil Apply in Chronic Hypoxia- induced Right Ventricular Hypertrophy and Atrial Fibrillation

作　　者：朱元州[1] 卢思稼[2] 田莉[3] 胡量子[1] 

机构地区：[1]武汉科技大学附属天佑医院重症医学科,湖北省武汉市430064 [2]海南省人民医院心内科 [3]华中科技大学同济医学院附属协和医院

出　　处：《中国全科医学》2014年第32期3880-3882,共3页Chinese General Practice

摘　　要：目的探讨钾离子通道开放剂（尼可地尔）在慢性缺氧诱导右心室肥厚及心房纤颤中的作用。方法预备120只健康SD大鼠（雌雄不限,250-300 g）,并采用随机数字表法将其分为Ⅰ-Ⅵ共6组进行干预处理,每组20只。Ⅰ组为空白对照组,Ⅱ组为尼可地尔组,Ⅲ组为慢性缺氧组,Ⅳ组为慢性缺氧＋尼可地尔组,Ⅴ组为慢性缺氧＋尼可地尔＋心房纤颤药物组,Ⅵ组为慢性缺氧＋心房纤颤药物组。Ⅰ组不给予任何药物干预;Ⅲ-Ⅵ组均给予慢性缺氧处理10 d;Ⅳ组和Ⅴ组在每次缺氧处理前30 min经大鼠尾静脉注射尼可地尔（0.8 mg/kg）,Ⅱ组同时给予尼可地尔（0.8 mg/kg）;Ⅴ组和Ⅵ组均在第6天开始使用氯化钙10 mg/ml和乙酰胆碱66μg/ml混合液,连用4 d。记录最后一次给药后大鼠发生心房纤颤持续时间及右心室肥厚指数（RVHI）。结果 6组大鼠RVHI比较,差异有统计学意义（P〈0.05）。Ⅲ、Ⅳ、Ⅴ、Ⅵ组大鼠RVHI分别与Ⅰ组和Ⅱ组比较,差异有统计学意义（P〈0.05）;Ⅰ组和Ⅱ组大鼠RVHI比较,差异无统计学意义（P〉0.05）;Ⅲ、Ⅳ、Ⅴ、Ⅵ组大鼠RVHI两两比较,差异无统计学意义（P〉0.05）。Ⅰ组和Ⅱ组大鼠未发生心房纤颤,Ⅲ、IV组有少部分大鼠发生心房纤颤,但发生时间和持续时间长短不一致。Ⅴ组和Ⅵ组大鼠经过慢性缺氧及心房纤颤药物诱导心律失常处理后,在实验进程第9天均出现心房纤颤。最后一次给药后,Ⅴ组大鼠心房纤颤持续时间短于Ⅵ组大鼠〔（18.63±1.70）s与（20.18±2.10）s;t=2.57,P〈0.05〕。结论尼可地尔可增强大鼠对慢性缺氧导致心房纤颤的耐受能力,降低心房纤颤持续时间;但短期内逆转心肌肥厚的作用不明显。Objective To study the organizational structure changes of right ventricle with chronic hypoxia- induced and potassium channel openers- Nicorandil intervention on chronic hypoxia- induced atrial fibrillation. Methods 120 SD rats were randomly divided into six groups Ⅰ- Ⅳ of the intervention process. Ⅰ group was the control group,Ⅱ group is the Nicorandil group,Ⅲ group is a group of chronic hypoxia,Ⅳ group is a chronic hypoxia and Nicorandil treatment group,Ⅴ group is a chronic hypoxia and Nicorandil and AF drug group,Ⅵ group is a group of chronic hypoxia and AF drugs. Ⅰ group,do not give any medical intervention; Ⅲ- Ⅵ group were given 10 days of chronic hypoxia,Ⅳ and Ⅴ groups in each group before hypoxia 30 minutes were given tail intravenous injection of Nicorandil（ 0. 8 mg /kg）,Ⅱ group also given Nicorandil（ 0. 8 mg /kg）in the same time; Ⅴ group and Ⅵ groups were given mixture in the sixth day of Calcium Chloride 10 mg /ml and acetylcholine 66μg/ml continuous administration of a mixture of four days,record rats AF duration and right ventricular hypertrophy index（ RVHI） after the last dose. Results There was significant difference of RVHI in 6 groups（ P 〈0.05）. There was significant difference of RVHI in Ⅲ,Ⅳ,Ⅴ,Ⅵ groups compared with group Ⅰ and group Ⅱ（ P 〈0. 05）. There was no significant difference of RVHI between group Ⅰ and Ⅱ（ P 〈0. 05）. Comparison of Ⅳ,Ⅴ,Ⅵ,RVHI of the rats in group two,the difference was not significant（ P 〈0. 05）. Group Ⅴ and Ⅵ rats after chronic hypoxia and atrial fibrillation drug induced arrhythmia after treatment,there were atrial fibrillation in the experimental process for ninth days. Group Ⅴ AF duration was shorter than group Ⅵ 〔（ 18. 63 ± 1. 70） s vs.（ 20. 18 ± 2. 10） s; t = 2. 57,P 〈0. 05〕. Conclusion Nicorandil enhanced rats tolerated the drug induced atrial fibrillation capacity,but for short- term reversal of cardiac hypertrophy is not obvious.

关 键 词：尼可地尔 缺氧 心室肥厚 心房颤动 心律失常 

分 类 号：R541.7[医药卫生—心血管疾病]