雷诺嗪与伊布利特联合应用对犬急性心房颤动的治疗作用  

Combined application of ranolazine and ibutilide on acute atrial fibrillation in dogs

作　　者：朱美飞[1] 徐杰 叶先才[3] 郑继锋 ZHU Meifei;XU Jie;YE Xiancai(Department of Critical Care Medicine,the First Affiliated Hospital of Zhejiang Chinese Medicine University,Hangzhou 310006,China)

机构地区：[1]浙江中医药大学附属第一医院重症医学科,杭州310006 [2]嘉兴市第二医院急诊科 [3]嘉兴学院医学院实验室 [4]嘉兴市第二医院心血管内科

出　　处：《浙江医学》2018年第11期1179-1182,共4页Zhejiang Medical Journal

基　　金：嘉兴市科技计划项目(2015AY23023)

摘　　要：目的探讨雷诺嗪和伊布利特合用对犬心房颤动的作用及心电生理的影响。方法在24只犬中成功建立了迷走神经性心房颤动模型18只,9只给予伊布利特静脉推注,9只给予雷诺嗪+伊布利特静脉推注,观察并比较两组药物对心房颤动转复为窦性心律的效果,终止过程中出现的室性心律失常情况,以及用药前后心房有效不应期(AERP)、QT、QTc、Tp-e间期的变化。结果伊布利特组转复成功率为77.8(7/9),雷诺嗪+伊布利特组转复成功率为88.9%(8/9),两组差异无统计学意义(P>0.05);伊布利特+雷诺嗪组转复时间较伊布利特组明显缩短,差异有统计学意义(P<0.05);转复过程中室性期前收缩的发生次数伊布利特组明显较伊布利特+雷诺嗪组高,差异有统计学意义(P<0.05);两组均未观察到发生尖端扭转型室性心动过速(Tdp);静脉推注药物后两组的QT间期、QTc间期、AERP均较基础状态明显延长,差异有统计学意义(P<0.05);伊布利特组Tp-e间期与基础状态比较有明显延长,差异有统计学意义(P<0.05);雷诺嗪+伊布利特组Tp-e间期与基础状态比较无明显变化(P>0.05)。结论 (1)雷诺嗪和伊布利特合用可以减少室性心律失常的发生;(2)雷诺嗪联合伊布利特对心房颤动的转复时间明显缩短。Objective To investigate the effects of combined application of ranolazine and ibutilideononan on vagotonic atrial fibrillation（AF） in dogs. Methods Vagotonic atrial fibrillation model was successfully established in 18 dogs. Ibutilide were given to 9 dogs（ibutilide group） and ibutilide with ranolazine were given to other 9 dogs（combination group）. The ability to terminate AF and the incidence of ventricular arrhythmias were assessed. The QT, QTc, Tp-e, atrial effective refractory period（AERP） were measured at baseline and after drug administration in two groups. Results Success rate to terminate AF between the two groups showed no significant difference（P〈0.05）.The time of termination in combination group was significantly shorter than that in ibutilide group（P〉0.05）. The incidence of premature ventricular in the ibutilide group was significantly higher than that in combination group in the process of recovery（P〈0.05）. No Tdp（Torsive VT） was observed in either group. The QT interval, QTc interval, AERP were significantly prolonged than those at baseline in both groups.Tp-e interval in ibutilide group was prolonged than that at baseline（P〈0.05）, but no significant changes in combination group（P〉0.05）.Conclusion Combined application of ranolazine and ibutilide can reduce the incidence of ventricular arrhythmias and significantly shorten the atrial fibrillation recovery time.

关 键 词：伊布利特 雷诺嗪 心房颤动 电生理学 

分 类 号：R541.75[医药卫生—心血管疾病]