过氧化氢对兔离体左室复极相关电生理指标及心律失常的影响  

The effect of hydrogen peroxide on the electrophysiological indexes of left ventricular repolarization and ararrhythmia in rabbit

作　　者：李云云 刘萌[1] 张雪梅 薛小临[1] 杨琳[1] 严干新 LI Yun-yun;LIU Meng;ZHANG Xue-mei;XUE Xiao-lin;YANG Lin;YAN Gan-xin(Department of Cardiology,First Affliated Hospital,School of Medicine of Xi'an Jiao Tong University,Xi'an 710061,Shaanxi;Xi Dian Group Hospital,Xi’an 710077,Shaanxi;Main Line Health Heart Center,Wynnewood,PA 19096,USA)

机构地区：[1]西安交通大学第一附属医院心内科,教育部环境与疾病相关基因离子通道病重点实验室,陕西西安710061 [2]西电集团医院,陕西西安710077 [3]Main Line Health Heart Center,Wynnewood,PA 19096,USA

出　　处：《中国心脏起搏与心电生理杂志》2021年第3期256-261,共6页Chinese Journal of Cardiac Pacing and Electrophysiology

基　　金：国家自然科学基金资助项目(编号:81370289)。

摘　　要：目的观察过氧化氢(H_(2)O_(2))对兔离体左室复极相关电生理指标及心律失常的影响。方法制备经冠状动脉灌注兔左室楔形组织块标本。实验分为对照组(灌注正常台式液)和实验组(灌注正常台式液+1.0 mmol/L H_(2)O_(2))。两组依次给予基础周长(BCL)为2 000、1 000、500 ms的刺激,持续时间依次为7、1、0.5 min,观察QT间期、T波峰值至终点的时程(Tp-e间期)、Tp-e/QT、ΔQT、ΔTp-e、ΔTp-e/QT、ΔQT%、ΔTp-e%、ΔTp-e/QT%的变化,及是否发生早后除极、晚后除极及室性心律失常。结果对照组和实验组QT间期、Tp-e间期均随刺激周长的增加而延长,且实验组呈现慢频率依赖性(P<0.01)。在2 000 ms BCL刺激下,对照组Tp-e/QT随时间无明显变化,但实验组Tp-e/QT随H_(2)O_(2)作用时间延长呈先增大后减小的变化趋势,其值始终大于对照组(3 min P<0.05,4~9 min P<0.01),而且与对照组相比实验组发生了不同程度的室性心律失常(P<0.001)。结论 H_(2)O_(2)对复极相关电生理指标的影响表现为慢频率依赖性;慢频率条件下,跨壁复极异质性的电生理指标呈先增大后减小的时间依赖性变化,同时也增加复极相关室性心律失常发生风险。Objective To observe the effect of H_(2)O_(2) on the electrophysiological indexes of left ventricular repolarization and arrhythmia in rabbits. Methods Established the arterially perfused rabbit left ventricular wedge preparations.The experiment was divided into two groups, the control group was perfused with normal Tyrode′s solution, and the experimental group was perfused with normal Tyrode′s solution and 1.0 mmol/L H_(2)O_(2). The basic cycle lengths was 2 000, 1 000, and 500 ms, and the duration was 7, 1, and 0.5 min, respectively, then observe QT interval, Tp-e interval, Tp-e/QT, ΔQT, ΔTp-e, ΔTp-e/QT, ΔQT%, ΔTp-e%, ΔTp-e/QT%, early after depolarization, delayed after depolarization, and ventricular arrhythmia. Results The QT and Tp-e intervals of the two groups were prolonged with the basic circle lengths, and the experimental group showed slow frequency dependence(P<0.01). Under stimulating at basic cycle lengths of 2 000 ms, the Tp-e/QT of the control group showed no significant change with time, however, the Tp-e/QT of the experimental group showed a trend of first increase and then decrease with the extension of H_(2)O_(2) stimulation time, and its value was always higher than that in the control group(3 min P<0.05,4-9 min P<0.01). Compared with the control group, different degrees of ventricular arrhythmia occurred in the experimental group(P<0.001). Conclusions The effect of H_(2)O_(2) on repolarization related electrophysiological indicators shows slow frequency dependence;Under the condition of slow frequency, the electrophysiological indicators about transmural repolarization heterogeneity increas first and then decrease in a time-dependent manner,and the risk of repolarization related ventricular arrhythmias is increased.[Chinese Journal of Cardiac Pacing and Electrophysiology,2021,35(3):256-261]

关 键 词：心血管病学 氧化应激 早期后除极 延迟后除极 Tp-e/QT 室性心律失常 

分 类 号：R541.7[医药卫生—心血管疾病] R331.3+8[医药卫生—内科学]