中华心律失常学杂志
中華心律失常學雜誌
중화심률실상학잡지
CHINESE JOURNAL OF CARDIAC ARRHYTHMIAS
2014年
1期
61-64
,共4页
张冉%赵圣刚%陈善浆%张玲玮%蒋芬芬%江力勤
張冉%趙聖剛%陳善漿%張玲瑋%蔣芬芬%江力勤
장염%조골강%진선장%장령위%장분분%강력근
左氧氟沙星%糖尿病兔%四氧嘧啶%跨壁复极离散度%室性心律失常
左氧氟沙星%糖尿病兔%四氧嘧啶%跨壁複極離散度%室性心律失常
좌양불사성%당뇨병토%사양밀정%과벽복겁리산도%실성심률실상
Levofloxacin%Diabetic rabbits%Tetraoxypyrimidine%Transmural dispersion of repolarization%Ventricular arrhythmia
目的 糖尿病患者QT间期延长反映了心脏的电不稳定性,这与心律失常的发生有关.作为临床常用的抗生素之一,左氧氟沙星可引起QT间期延长,甚至引起致命性尖端扭转性室性心动过速(Tdp).本研究旨在评估左氧氟沙星对糖尿病兔的致心律失常作用.方法 健康新西兰大白兔30只,体重2.0～2.5 kg,雌雄各半,应用随机数字法分为对照组(n=10)和实验组(n=20).实验组经耳缘静脉注射5％四氧嘧啶160 mg/kg建立糖尿病兔模型,对照组兔注射相同剂量的生理盐水.72 h后监测兔空腹血糖,若空腹血糖值大于基础血糖值的3倍,视为建模成功.饲养4周后制作冠状动脉灌流的左心室楔形心肌模型,分别灌注左氧氟沙星(1.14 mg/ml),比较灌注左氧氟沙星前后对照组兔和糖尿病兔跨壁心电图QT间期、左心室心肌内膜、外膜细胞的动作电位时限(APD)、跨壁复极离散度(TDR)及室性心律失常的发生率.结果 与对照组相比,糖尿病兔心肌QT间期延长19％,糖尿病内膜、外膜APD明显延长,跨壁复极离散度增大,早后除极发生率为36％,心室颤动(室颤)发生率18％.灌注左氧氟沙星后,对照组心肌QT间期、内膜、外膜APD均延长,跨壁复极离散度增大,早后除极发生率60％,所有心肌均未发生室颤;糖尿病组心肌QT间期、内膜、外膜APD、跨壁复极离散度均显著增大,早后除极的发生率为63％,心室颤动发生率为45％,室性心律失常发生率显著增加(P＜0.05).结论 左氧氟沙星引起糖尿病兔QT间期延长,跨壁复极离散度异常增大.与对照组相比,糖尿病组灌注左氧氟沙星后更易发生心律失常.
目的 糖尿病患者QT間期延長反映瞭心髒的電不穩定性,這與心律失常的髮生有關.作為臨床常用的抗生素之一,左氧氟沙星可引起QT間期延長,甚至引起緻命性尖耑扭轉性室性心動過速(Tdp).本研究旨在評估左氧氟沙星對糖尿病兔的緻心律失常作用.方法 健康新西蘭大白兔30隻,體重2.0～2.5 kg,雌雄各半,應用隨機數字法分為對照組(n=10)和實驗組(n=20).實驗組經耳緣靜脈註射5％四氧嘧啶160 mg/kg建立糖尿病兔模型,對照組兔註射相同劑量的生理鹽水.72 h後鑑測兔空腹血糖,若空腹血糖值大于基礎血糖值的3倍,視為建模成功.飼養4週後製作冠狀動脈灌流的左心室楔形心肌模型,分彆灌註左氧氟沙星(1.14 mg/ml),比較灌註左氧氟沙星前後對照組兔和糖尿病兔跨壁心電圖QT間期、左心室心肌內膜、外膜細胞的動作電位時限(APD)、跨壁複極離散度(TDR)及室性心律失常的髮生率.結果 與對照組相比,糖尿病兔心肌QT間期延長19％,糖尿病內膜、外膜APD明顯延長,跨壁複極離散度增大,早後除極髮生率為36％,心室顫動(室顫)髮生率18％.灌註左氧氟沙星後,對照組心肌QT間期、內膜、外膜APD均延長,跨壁複極離散度增大,早後除極髮生率60％,所有心肌均未髮生室顫;糖尿病組心肌QT間期、內膜、外膜APD、跨壁複極離散度均顯著增大,早後除極的髮生率為63％,心室顫動髮生率為45％,室性心律失常髮生率顯著增加(P＜0.05).結論 左氧氟沙星引起糖尿病兔QT間期延長,跨壁複極離散度異常增大.與對照組相比,糖尿病組灌註左氧氟沙星後更易髮生心律失常.
목적 당뇨병환자QT간기연장반영료심장적전불은정성,저여심률실상적발생유관.작위림상상용적항생소지일,좌양불사성가인기QT간기연장,심지인기치명성첨단뉴전성실성심동과속(Tdp).본연구지재평고좌양불사성대당뇨병토적치심률실상작용.방법 건강신서란대백토30지,체중2.0～2.5 kg,자웅각반,응용수궤수자법분위대조조(n=10)화실험조(n=20).실험조경이연정맥주사5％사양밀정160 mg/kg건립당뇨병토모형,대조조토주사상동제량적생리염수.72 h후감측토공복혈당,약공복혈당치대우기출혈당치적3배,시위건모성공.사양4주후제작관상동맥관류적좌심실설형심기모형,분별관주좌양불사성(1.14 mg/ml),비교관주좌양불사성전후대조조토화당뇨병토과벽심전도QT간기、좌심실심기내막、외막세포적동작전위시한(APD)、과벽복겁리산도(TDR)급실성심률실상적발생솔.결과 여대조조상비,당뇨병토심기QT간기연장19％,당뇨병내막、외막APD명현연장,과벽복겁리산도증대,조후제겁발생솔위36％,심실전동(실전)발생솔18％.관주좌양불사성후,대조조심기QT간기、내막、외막APD균연장,과벽복겁리산도증대,조후제겁발생솔60％,소유심기균미발생실전;당뇨병조심기QT간기、내막、외막APD、과벽복겁리산도균현저증대,조후제겁적발생솔위63％,심실전동발생솔위45％,실성심률실상발생솔현저증가(P＜0.05).결론 좌양불사성인기당뇨병토QT간기연장,과벽복겁리산도이상증대.여대조조상비,당뇨병조관주좌양불사성후경역발생심률실상.
Objective The abnormal prolongation in QT interval in diabetics reflects the electric instability of heart,which is related to the incidence of cardiac arrhythmia.As one of the frequently used antibiotics in clinical practice,levofloxacin may prolong QT interval,or even lead to lethal ventricular arrhythmia-torsade de pointes(Tdp).The present study was to assess the arrhythmogenic effect of levofloxacinin on diabetic rabbits.Methods Thirty healthy New Zealand rabbits weighing 2.0-2.5 kg were randomized into the control group (n=10)and the test group(n =20).The rabbits in test group were injected with 5％ tetraoxypyrimidine in a dosage of 160 mg/kg via the marginal vein to establish the diabetic rabbits model,while the control group was injected with the same volume of saline.The arterially perfused rabbit ventricular wedge preparations were produced four weeks later,which were infused with levofloxacin(1.14 mg/ml),and transmural ECG and action potential period from both endocardium(APDEndo)and epicardium(APDEpi)were simultaneously recorded and compared.Results The QT interval,APDEndo,APDEpi,,and transmural dispersion of repolarization(TDR) of diabetic rabbits were prolonged,the incidence rate of early after-depolarization(EAD) and ventricular fibrillation(VF) increased (P＜0.05).After perfusion with levofloxacin,the QT interval,APDEndo and APDEpi,TDR were longer,the incidence rate of EAD and VF were increased in test group(P＜0.05).Conclusion In comparison to the control group,ventricular arrhythmia is liable to be induced after levofloxacin perfusion in the diabetic group.
