CAJ | 학술논문

目的：探讨迷走神经对心房颤动的作用。方法成年健康杂种犬8只，分别按顺序完成3个实验：单纯迷走神经刺激（ A组）、阿托品＋迷走神经刺激（ B组）、切除上腔静脉中部和主动脉根部（ SVC-AO ）脂肪垫＋迷走神经刺激（ C组），完成每个实验后约间隔30 min再开始下一个实验。分别于切除脂肪垫、静滴阿托品及迷走神经刺激前后测定有效不应期（采用基础刺激周长逆减程序刺激方法）及房颤诱发数据（采用程序刺激和猝发刺激方法）。结果迷走神经刺激前各组心房和肺静脉有效不应期、各部位心房颤动诱发率、心房颤动持续时间比较，差异均无统计学意义（P＞0．05）；迷走神经刺激后实验A组心房和肺静脉有效不应期均明显短于B组、C组（P＜0．05），A组多数部位心房颤动诱发率明显高于 B组、C组（P＜0．05），A组心房颤动持续时间明显长于B组、C组（ P＜0．05）；但刺激后B组、C组上述指标比较，差异均无统计学意义（ P＞0．05）。结论切除SVC-AO脂肪垫能阻断迷走神经张力增高所致心房和肺静脉的电重构，有效阻止心房颤动的发生与维持。
목적：탐토미주신경대심방전동적작용。방법성년건강잡충견8지，분별안순서완성3개실험：단순미주신경자격（ A조）、아탁품＋미주신경자격（ B조）、절제상강정맥중부화주동맥근부（ SVC-AO ）지방점＋미주신경자격（ C조），완성매개실험후약간격30 min재개시하일개실험。분별우절제지방점、정적아탁품급미주신경자격전후측정유효불응기（채용기출자격주장역감정서자격방법）급방전유발수거（채용정서자격화졸발자격방법）。결과미주신경자격전각조심방화폐정맥유효불응기、각부위심방전동유발솔、심방전동지속시간비교，차이균무통계학의의（P＞0．05）；미주신경자격후실험A조심방화폐정맥유효불응기균명현단우B조、C조（P＜0．05），A조다수부위심방전동유발솔명현고우 B조、C조（P＜0．05），A조심방전동지속시간명현장우B조、C조（ P＜0．05）；단자격후B조、C조상술지표비교，차이균무통계학의의（ P＞0．05）。결론절제SVC-AO지방점능조단미주신경장력증고소치심방화폐정맥적전중구，유효조지심방전동적발생여유지。
Objective To investigate the effects of vagus nerve on atrial fibrillation (AF).Methods Eight healthy adult mongrel dogs were subjected to three experiments .The dogs in group A were treated with vagus nerve stimulation ,in group B were treated with atropine administration and vagus nerve stimulation ,and in group C were treated with the removal of fat pad locating between the medial superior vena cava and aortic root (SVC-AO fat pad) plus vagus nerve stimulation. There was a 30-minute interval between two experiments .The effective refractory period ( ERP) and inductive incidence of AF were measured before and after SVC-AO fat pad removal ,intravenous drip of atropine as well as vagus nerve stimulation , respectively .Results Before vagus nerve stimulation , there were no significant differences in the atrial and pulmonary venous ERPs,inductive rate and duration of AF among three groups (P>0.05).After vagus nerves stimulation,the atrial and pulmonary venous ERPs in group A were significantly shorter than those in group B or group C (P<0.05),the inductive rates of AF at most sites in group A were significantly higher than those in group B or group C (P<0.05),and the duration of AF in group A was significantly longer than that in group B or group C (P<0.05).After vagus nerves stimulation ,there were no significant differences in the indexes above between group B and group C ( P>0 .05 ) .Conclusion SVC-AO fat pad removal can effectively prevent the atrial and pulmonary venous electrial remodeling caused by increased vagal tone as well as the development and maintenance of AF .