不同温度下七氟烷对兔心肌单相动作电位及跨室壁复极离散度的影响.docVIP

不同温度下七氟烷对兔心肌单相动作电位及跨室壁复极离散度的影响 贵阳医学院附属医院麻醉科,贵阳 550004 杨烨 高鸿 【摘要】 目的 了解常温和低温下七氟烷（Sevoflurane, Sevo）Sevo 0.65MAC组（S1组）、常温Sevo 1.3MAC组（S2组）；低温组（30 oC）：低温对照组（C′组）、低温Sevo 0.65MAC组（S1′组）、低温Sevo 1.3MAC组（S2′组）。各组分别行Langendorff 逆行离体心脏灌注，同步记录左心室前壁外膜（epicardium,Epi）、中层(mid-myocardium,Mid)、内膜(endocardium,Endo) 三层心肌MAP。观察单相动作电位时程（monophasic action potential duration,MAPD）及有无早期后除极（early after depolarization, EAD）、延迟后除极（delay after depolarization, DAD），计算单相动作电位复极90％的时程（MAPD90）、跨室壁复极离散度（transmural dispersion of repolarization , TDR）。结果 各组均未发现EAD、DAD；各组3层心肌MAPD90及TDR的比较：与C组比较，C′组三层心肌MAPD90均明显延长(P0.05)。其余各组间比较均无统计学差异（P0.05）；各组间TDR比较均无统计学差异（P0.05）；析因分析比较S1′、S2′组，七氟烷与低温无交互作用（P0.05）。仅表现为低温的主效应使MAPD90明显延长（P0.05）；低温组在低温灌注后有三例出现频发室早、阵发性室速等，经灌注七氟烷后，心律失常均得以改善。 结论 七氟烷在常温和低温下对心肌单相动作电位及跨室壁复极不均一性均无明显影响，不引起触发活动，且无剂量依赖性；低温显著延长三层心肌的复极时间，可引起频发室早及阵发室速等心律失常；七氟烷可改善低温引起的心律失常。 【关键词 】七氟烷;低温;单相动作电位;复极离散度;兔;心肌 Effects of Sevoflurane on cardiac monophasic action potential and transmural dispersion of repolarization in isolated rabbit hearts in different temperature Yang Ye, Gao Hong. Department of Anesthesiology, the affiliated hospital of Guiyang medical college, Guiyang 550004, China [Abstract] objective To oberve the effects of Sevoflurane(Sevo) on the monophasic action potential (MAP) and transmural dispersion of repolarization (TDR) in isolated rabbit hearts in different temperature. Methods Forty eight healthy rabbits weighing 1.5-2.0 kg were randomly divided into 6 groups (n=8 each), normal temperature groups（37 oC）: control group (group C), Sevoflurane 0.65MAC group (group S1) and Sevoflurane 1.3MAC group (group S2). Hypothermia groups（30 oC）: control group (group C′),Sevoflurane 0.65MAC group (group S1′) and Sevoflurane 1.3MAC group (group S2′) . The animals were intraperitoneal injection with heparin 2mg/kg and intravenous anesthetized with 3% pentobarbital sodium 30mg/kg. Ten minutes later, the chest was opened and the heart was excised rapidly. Isolated hear