缺血预适应对短期冬眠心肌动物模型QT离散度及心律失常的影响.docVIP

缺血预适应对短期冬眠心肌动物模型QT离散度及心律失常的影响 作者：杨煜 夏勇 李东野 潘德峰 钱文浩 朱红 张延斌 陈清枝 【摘要】 目的 观察缺血预适应（IPC）对短期冬眠心肌（SHM）动物模型心律失常的发生情况及QT离散度(QTd)的影响。方法 12只中国小型家猪应用闭胸法制备SHM模型，随机分为2组：①对照组(n=6），只制备SHM模型；②缺血预适应组（IPC组，n=6），制备SHM模型前给予缺血5 min、再灌注5 min处理，重复2次。于基础状态、冠状动脉狭窄后10、30、60、120 min记录同步12导联心电图，计算QTd。同时，记录实验过程中心律失常的发生情况，计算心律失常评分。结果 2组家猪基础状态时QTd差异无显著性（Pgt;0.05），冠状动脉狭窄后各时间点QTd较基础状态均明显增加（P＜0.01），但IPC组较对照组明显降低（P＜0.01）。IPC组心律失常评分较对照组明显降低（P＜0.01）。结论 IPC明显降低SHM动物模型QTd的增加，并可减少心律失常的发生。 【关键词】 冬眠心肌；缺血预处理；QT离散度；心律失常；动物模型；家猪 Abstract: Objective To observe the effects of ischemic preconditioning on the QT dispersion (QTd) and incidence of arrhythmias in an animal model of short-term hibernating myocardium (SHM). Methods 12 little domestic Chinese pigs used to establish the model of SHM by interventional method (closed-chest), were divided into 2 groups at random: the control group (CON group, n=6) and the ischemic preconditioning group (IPC group, n=6). IPC was conducted by making 2 cycles of 5-min ischemia followed by 5-min reperfusion before the establishment of model. The 12-lead electrocardiogram recording was taken at different time points to calculate QTd and grade arrhythmia. Results The QTd were similar at the basal line in the two groups, and increased significantly at all the time points after the coronary artery was stenosed. The QTd was much lower in IPC group than in CON group; the arrhythmia score was lower in IPC group than in CON group. Conclusion IPC can reduce the increment of QTd and decrease the incidence of arrhythmia in SHM model. Key words: hibernating myocardium; ischemic preconditioning; QT dispersion; arrhymia；animal model; pig 缺血预适应（IPC）是由Murry等［1］首先在犬心肌模型中证实，是指心肌短暂缺血对随后发生的持续严重缺血的保护作用。其后，诸多研究证实在狗、猪、兔和大鼠等动物中均存在IPC现象［2］。大多数研究报道IPC能降低心肌缺血/再灌注（ischemic/reperfusion, IR）损伤后心律失常的发生，但也有研究认为IPC能促进其发生［3］。目前，IPC对冠状动脉持续低血流所致冬眠心肌QT离散度（QTd）及心律失常发生情况的影响少见报道。因此，本实验应用闭胸法建立短期冬眠心肌（SHM）动物模型,探讨IPC对其QTd及心律失常的影响。 1 材料和方法 1.1 实验动物 12只中国小型家猪，3～5