不同浓度瑞芬太尼对家兔心肌单相动作电位的影响  

Effects of different concentrations of remifentanil on monophasic action potential in isolated rabbit hearts

作　　者：刘艳秋[1] 高鸿[1] 张凯强[1] 安丽[1] 李惠[1] 熊永红[1] 

机构地区：[1]贵州医科大学附属医院麻醉科,贵阳市550004

出　　处：《中华麻醉学杂志》2016年第5期542-545,共4页Chinese Journal of Anesthesiology

基　　金：贵州省科技厅联合基金（黔科合LH字[2015]7424号）;贵州省大学生创新创业训练计划项目（201510660022）

摘　　要：目的评价不同浓度瑞芬太尼对家兔心肌单相动作电位的影响。方法成年家兔，体重2．0～2．5kg，雌雄不拘，成功制备Langendorff离体心脏灌注模型24个，采用随机数字表法，将其分为4组（n=6）：对照组（C组）和不同浓度瑞芬太尼组（R1组、R2组和R3组）。平衡灌注15min时C组继续灌注K—H液60min；R1组-R3组分别灌注含12、25、50ng／ml瑞芬太尼的K—H液60min。记录平衡灌注15min、继续灌注15、30、60min时HR、左心室前壁三层心肌单相动作电位0期最大上升速率（Vmax）、振幅（MAPA），计算动作电位复极90％的时程（APD90）和跨室壁复极离散度（TDR）。结果与C组比较，R1组-R3组继续灌注15、30、60min时HR减慢，APD90和TDR延长（P〈0．05）；与C组和R1组比较，R2组和R3组继续灌注15、30、60min时Vmax减慢，MAPA降低（P〈0．05）。结论低浓度瑞太芬尼通过增加家兔心肌单相动作电位TDR诱发心脏传导阻滞，而高浓度瑞太芬尼通过抑制家兔心肌单相动作电位去极和增加TDR诱发心脏传导阻滞。Objective To evaluate the effects of different concentrations of remifentanil on myocar- dial monophasic action potential （MAP） in isolated rabbit hearts. Methods Adult rabbits of both sexes, weighing 2.0-2.5 kg, were used in the study. Their hearts were excised, and retrogradely perfused with oxygenated K-H solution saturated with 95~O2-5%CO2 at 37 ~C in a Langendorff apparatus. Twenty-four i- solated hearts were randomly divided into 4 groups （ n = 6 each） using a random number table： control group （group C） and 3 different concentrations of remifentanil groups （group R1.3 ）. After 15 min of stabili- zation, K-H solution was continuously perfused for 60 min in group C, and K-H solution containing 12, 25 and 50 ng/ml remifentanil was continuously perfused for 60 min in Rl , R2 and R3 groups, respectively. At 15 rain of stabilization, and 15, 30 and 60 min of perfusion with K-H solution, the heart rate, and the maximal velocity and amplitude of the MAP in the three layers of the left ventricular anterior wall were recor- ded, and the action potential duration at 90% repolarization and transmural dispersion of repolarization （TDR） were calculated. Results Compared with group C, the heart rate was significantly decreased, and the action potential duration at 90% repolarization and TDR were significantly prolonged at 15, 30 and 60 rain of perfusion in RI_3 groups （P〈0.05）. Compared with C and Rl groups, the maximal velocity and amplitude of MAP were significantly decreased at 15, 30 and 60 min of perfusion in R1 and R3 groups （P〈 0.05）. Conclusion Low-concentration remifentanil induces heart block through increasing TDR, howev- er, high-concentration remifentanil induces heart block through inhibiting myocardial MAP depolarization and increasing TDR in the isolated rabbit hearts.

关 键 词：哌啶类 动作电位 心律失常 心性 

分 类 号：R965[医药卫生—药理学]