切断左侧T3-T4交感干对建立持续性心房颤动模型的影响  

Effects of left T3-T4 sympathicotomy on the establishment of persistent atrial fibrillation model

作　　者：姜兆磊[1] 蔡捷 梅举[1] 沈赛娥[2] 汤敏[1] 马南[1] 刘浩[1] JIANG Zhao-lei;CAI Jie;MEI Ju;SHEN Sai-e;TANG Min;MA Nan;LIU Hao(Department of Cardiothoracic Surgery,Xinhua Hospital,School of Medicine,Shanghai Jiaotong University,Shanghai 200092,China;Department of Anesthesiology,Xinhua Hospital,School of Medicine,Shanghai Jiaotong University,Shanghai 200092,China)

机构地区：[1]上海交通大学医学院附属新华医院心胸外科,上海市200092 [2]上海交通大学医学院附属新华医院麻醉科,上海市200092

出　　处：《中国心血管病研究》2020年第2期151-154,共4页Chinese Journal of Cardiovascular Research

基　　金：国家自然科学基金项目(81600264、81570290、81974023);国家临床重点专科项目:上海市科委科研计划项目(19411963800);上海青年医师资助培养计划:上海新华医院院级科研课题(15YJ13)。

摘　　要：目的研究切断左侧T3-T4交感干对建立持续性心房颤动(房颤)的影响.方法成年健康雄性比格犬12只,体重20~26 kg.随机等分为两组(对照组和实验组),每组各6只.对照组:只应用左心房快速起搏建立犬持续性房颤模型,不做其他处理;实验组:先用剪刀分别在左侧T3上端及T4下端切断T3-T4交感干,再应用左心房快速起搏建立犬持续性房颤模型.在T3-T4交感干切断后30 min、持续性房颤模型构建成功后1个月,分别记录比较两组犬的心室率;并比较两组犬持续性房颤模型的构建时间.结果实验组犬构建成持续性房颤的起搏时间,较对照组犬明显延长[对照组(4.5±1.0)周,实验组(7.7±1.4)周,P=0.001,t=-4.503].与对照组相比,分离、切断左侧T3-T4交感干后30 min[对照组(87.2±2.0)次/min,实验组(82.3±2.4)次/min,P=0.004,t=3.738]和持续性房颤构建成功1个月时[对照组(138.5±2.9)次/min,实验组(127.7±3.9)次/min,P<0.001,t=5.490],实验组犬的平均心室率均明显减慢.结论切断T3-T4交感干可以延长持续性房颤的构建时间,并明显减慢持续性房颤犬的快速心室率,表明切断左侧T3-T4交感干可以有效抑制房颤的触发和维持.Objective The aim of this study is to explore the effects of left T3-T4 sympathicotomy on the establishment of persistent atrial fibrillation(AF).Methods 12 mature healthy male beagle dogs(20-26 kg)were selected.They were randomly halved to two groups(experimental group and control group,6 dogs each group).The control group was merely performed with rapid left atrial pacing to induce persistent AF.The experimental group was treated with left T3-T4 sympathicotomy and rapid left atrial pacing simultaneously.Ventricular rate(VR)was monitored separately at 30 minutes after left T3-T4 sympathicotomy and one month after persistent AF was documented.Results Persistent AF inducing time of the experimental group(7.7±1.4)weeks was longer than that of the control group(4.5±1.0)weeks(P=0.001,t=-4.503).At 30 minutes after left T3-T4 sympathicotomy,average VR was(82.3士2.4)times/min in experimental group,which was significantly slower than that of control group(87.2±2.0)tim es/m in(P=0.004,/=3.738).After persistent AF was documented for 1 month,average VR of experimental group(127.7±3.9)times/min was also significantly slower than that of control group(138.5±2.9)times/min(P<0.001,t=5.490).Conclusion Left T3-T4 sympathicotomy could prolong the inducing time of persistent AF and reduce the fast VR during AF in ambulatory dogs with pacing induced persistent AF,which demonstrated that left T3-T4 sympathicotomy could effectively inhibit the occurrence and maintenance of AF.

关 键 词：心房颤动 交感神经 交感神经切断术 心室率 

分 类 号：Q95-33[生物学—动物学] R541.7[医药卫生—心血管疾病]