心电与循环
心電與循環
심전여순배
Journal of Electrocardiology(China)
2014年
1期
32-34,43
,共4页
蒋芬芬%张玲玮%江力勤%张建勤
蔣芬芬%張玲瑋%江力勤%張建勤
장분분%장령위%강력근%장건근
动作电位时程%跨壁复极离散度%楔形心肌组织块
動作電位時程%跨壁複極離散度%楔形心肌組織塊
동작전위시정%과벽복겁리산도%설형심기조직괴
Action potential duration%Transmural dispersion of repolarization%Myocardial wedge preparation
目的探讨美西律、索他洛尔、索他洛尔+美西律口服后对家兔左心室楔形心肌组织块电生理特性的影响。方法建立冠状动脉灌注的家兔左心室楔形心肌组织块模型，应用浮置玻璃微电极和心电图同步记录技术，观察美西律、索他洛尔、索他洛尔+美西律口服后对家兔内外层心肌细胞的动作电位时程（APD）、跨壁复极离散（TDR）的影响。结果美西律组内、外膜心肌细胞的APD、Q- T间期及TDR在不同刺激周长下均较对照组缩短，索他洛尔组均较对照组延长，且以内膜延长为主（均P＜0.05），索他洛尔+美西律组较对照组仅轻微延长，差异无统计学意义，但较索他洛尔组缩短（P＜0.05）。美西律组、索他洛尔+美西律组心律失常发生率与对照组比较差异无统计学意义，索他洛尔组心律失常发生率高较对照组升高（P＜0.05）。结论美西律可明显缩短内、外膜心肌细胞的APD、Q- T间期，并可减小心肌细胞的TDR，索他洛尔相反，抗心律失常同时容易导致心律失常，联合应用美西律可逆转索他洛尔对兔心肌电生理的不利作用，从而提高安全性。
目的探討美西律、索他洛爾、索他洛爾+美西律口服後對傢兔左心室楔形心肌組織塊電生理特性的影響。方法建立冠狀動脈灌註的傢兔左心室楔形心肌組織塊模型，應用浮置玻璃微電極和心電圖同步記錄技術，觀察美西律、索他洛爾、索他洛爾+美西律口服後對傢兔內外層心肌細胞的動作電位時程（APD）、跨壁複極離散（TDR）的影響。結果美西律組內、外膜心肌細胞的APD、Q- T間期及TDR在不同刺激週長下均較對照組縮短，索他洛爾組均較對照組延長，且以內膜延長為主（均P＜0.05），索他洛爾+美西律組較對照組僅輕微延長，差異無統計學意義，但較索他洛爾組縮短（P＜0.05）。美西律組、索他洛爾+美西律組心律失常髮生率與對照組比較差異無統計學意義，索他洛爾組心律失常髮生率高較對照組升高（P＜0.05）。結論美西律可明顯縮短內、外膜心肌細胞的APD、Q- T間期，併可減小心肌細胞的TDR，索他洛爾相反，抗心律失常同時容易導緻心律失常，聯閤應用美西律可逆轉索他洛爾對兔心肌電生理的不利作用，從而提高安全性。
목적탐토미서률、색타락이、색타락이+미서률구복후대가토좌심실설형심기조직괴전생리특성적영향。방법건립관상동맥관주적가토좌심실설형심기조직괴모형，응용부치파리미전겁화심전도동보기록기술，관찰미서률、색타락이、색타락이+미서률구복후대가토내외층심기세포적동작전위시정（APD）、과벽복겁리산（TDR）적영향。결과미서률조내、외막심기세포적APD、Q- T간기급TDR재불동자격주장하균교대조조축단，색타락이조균교대조조연장，차이내막연장위주（균P＜0.05），색타락이+미서률조교대조조부경미연장，차이무통계학의의，단교색타락이조축단（P＜0.05）。미서률조、색타락이+미서률조심률실상발생솔여대조조비교차이무통계학의의，색타락이조심률실상발생솔고교대조조승고（P＜0.05）。결론미서률가명현축단내、외막심기세포적APD、Q- T간기，병가감소심기세포적TDR，색타락이상반，항심률실상동시용역도치심률실상，연합응용미서률가역전색타락이대토심기전생리적불리작용，종이제고안전성。
Objective To investigate the effect of Mexiletine, Sotalol and Sotalol with Mexiletine on electrophysiological characteristics of rabbit left ventricle. Methods The effects of Mexiletine, Sotalol and Sotalol with Mexiletine taken oral y on action potential duration (APD) and transmural dispersion of repolarization (TDR) of the epicardium and endocardium were observed by simultaneous recording with floating glass microelectrode and electrocardiogram in an established arterial y perfused wedge of rabbit left ventricle. Results Under different stimulations, Q- T interval, APD and TDR of the epicardi-um and endocardium were significantly shortened in Mexiletine group, significantly prolonged in Sotalol group with much more in the endocardium(P<0.05), and slightly prolonged in Mexiletine with Sotalol group(P<0.05), which was significantly shorter than Sotalol group. The rate of arrhythmia was significantly higher in Sotalol group (P<0.05), but not in Mexiletine group and Sotalol with Mexiletine group, compared to control group. Conclusion Mexiletine reduces, while Sotalol in-creases, APD、Q- T interval and TDR of the epicardium and endocardium. Sotalol has both anti- and pro- arrhythmia effects. Combined application of Mexiletine can reverse the adverse effects of Sotalol on myocardial electrophysiology of rabbit and increase its security.
