胺碘酮导管灌注对射频消融术后家兔心射频损伤灶、心肌细胞凋亡及心功能的影响  

Effects of amiodarone catheter perfusion on radiofrequency lesion,myocardial apoptosis and cardiac function in rabbits after radiofrequency ablation

作　　者：黄明伟 许朝祥[1] 徐源[1] 张文兵[1] 王耀国[1] Huang Mingwei;Xu Chaoxiang;Xu Yuan;Zhang Wenbing;Wang Yaoguo(Department of Cardiovascular Medicine,The Second Affiliated Hospital of Fujian Medical University,Quanzhou 362000,China)

机构地区：[1]福建医科大学附属第二医院心血管内科,泉州362000

出　　处：《解剖学杂志》2023年第2期98-104,共7页Chinese Journal of Anatomy

基　　金：福建医科大学启航基金(2018QH1099);泉州市科技项目(2019N098S)。

摘　　要：目的:探讨胺碘酮导管灌注对射频消融术后家兔心射频损伤灶、心肌细胞凋亡及心功能的影响。方法:家兔分为假手术组、心房颤动模型组、射频消融组及射频+胺碘酮组,除假手术组外均建立心房颤动模型,射频消融组进行射频消融治疗,射频+胺碘酮组在射频消融治疗的同时用胺碘酮导管灌注组织。用电子心电图检测各组家兔心电图;多普勒超声检测心功能;H-E染色和透射电镜术检测心组织射频损伤;TUNEL法检测心肌细胞凋亡;免疫印迹检测各组Bcl-2、Bax、caspase-3和9表达。结果:与假手术组相比,模型组心率升高,RR间期降低,QRS及QT间期升高。与模型组相比,射频消融组房颤诱发时间延长,持续时间更短,心率降低,RR间期升高,QRS及QT间期降低;与射频消融组相比,射频+胺碘酮组房颤诱发时间延长,持续时间更短,心率降低,RR间期升高,QRS及QT间期降低。与假手术组相比,模型组家兔左心房射血分数(LVEF)、左心室缩短分数(LVFS)降低,左心室收缩末期内径(LVESD)及左心室舒张末期内径(LVEDD)升高;与模型组相比,射频消融组家兔LVEF、LVFS升高,LVESD及LVEDD降低;与射频消融组相比,射频+胺碘酮组家兔LVEF、LVFS升高,LVESD及LVEDD降低。H-E染色及电镜结果显示模型组家兔心肌组织、细胞肌节结构紊乱;射频消融组心肌组织紊乱加剧;射频消融+胺碘酮组家兔心肌结构及细胞肌节紊乱程度降低。与假手术组相比,模型组Bcl-2降低,心肌细胞凋亡率、Bax、caspase-3及caspase-9升高;与模型组相比,射频消融组Bcl-2降低,心肌细胞凋亡率、Bax、caspase-3及caspase-9升高;与射频消融组相比,射频+胺碘酮组Bcl-2升高,心肌细胞凋亡率、Bax、caspase-3及caspase-9降低。结论:心房颤动家兔采用射频消融术后心电图及心功能改善,但心肌组织损伤及心肌细胞凋亡加剧,胺碘酮导管灌注可减少心肌组织射频损伤,降低心肌细胞凋亡率Objective:To investigate the effects of amiodarone catheter perfusion on radiofrequency lesion,myocardial apoptosis,and cardiac function in rabbits after radiofrequency ablation.Methods:Rabbits were divided into the sham group,atrial fibrillation(AF)model group,radiofrequency ablation group and radiofrequency+amiodarone group.AF models were established except the sham group,and the radiofrequency ablation group underwent radiofrequency ablation therapy.In radiofrequency+amiodarone group,tissues were infused with amiodarone catheter at the same time of radiofrequency ablation,and electrocardiogram of rabbits in each group was detected by electronic electrocardiogram.Doppler ultrasound was used to detect cardiac function.Radiofrequency injury of heart tissue was detected by H-E staining and electronic microscopy.Myocardial apoptosis rate was detected by TUNEL method.The expressions of Bcl-2,Bax and caspase-3/9 in each group were detected by Western blotting.Results:Compared with the sham group,the model group had higher heart rate(HR),lower RR interval,and higher QRS and QT interval.Compared with the model group,the radiofrequency ablation group had longer AF induction time and shorter duration,lower HR,higher RR interval,lower QRS and QT interval.Compared with the radiofrequency ablation group,the radiofrequency+amiodarone group had longer radiofrequency induction time,shorter duration,lower HR.RR interval increased,and QRS and QT interval decreased.Compared with the sham group,LVEF and LVFS of rabbits in the model group were decreased,while LVESD and LVEDD were increased.Compared with the model group,LVEF and LVFS of rabbits in the radiofrequency ablation group were increased.while LVESD and LVEDD were decreased.Compared with the radiofrequency ablation group,LVEF and LVFS of rabbits in the radiofrequency ablation group were increased.LVESD and LVEDD decreased.The results of H-E staining and electron microscopy showed that the myocardial tissue and cell myome structure of rabbits in the model group were disordere

关 键 词：心房颤动 射频消融 胺碘酮 心功能 心肌细胞 家兔 

分 类 号：R541.75[医药卫生—心血管疾病]