心脏钠电流与其他离子流的相互作用及其临床意义 - 中华老年多器官 .doc

·综 述· 心脏钠电流与其他离子流的相互作用及其临床意义 吴志娟，李 泱* （解放军总医院心内科，北京 100853） 【摘 要】心肌细胞膜上的离子流共同参与心脏在生理及病理下的电活动。钠离子流（INa）参与心肌细胞动作电位（AP）的除极和复极过程，对动作电位的传导有重要作用。故研究心脏钠通道与各离子通道的离子流相互关系及影响，意义尤为重要。本文综述了钠离子流与心脏其他离子流间的相互作用关系，试图从离子流相互作用的角度解释心律失常的发生机制。 【关键词】钠离子流；心脏离子流；动作电位；心律失常，心性 【中图分类号】 R541.7; R337.5 【文献标识码】 A 【DOI】 ? Interaction of cardiac sodium current with other ion channel currents and its clinical significance WU Zhi-Juan, Li Yang* (Department of Vasculocardiology, Chinese PLA General Hospital, Beijing 100853, China) 【Abstract】 Various ion currents on the myocardial cell membrane take part in cardiac electric activity under both physiological and pathological conditions. Cardiac sodium current (INa) is involved in the depolarization and repolarization of cardiomyocyte action potential (AP), and exerts important effect on the conduction of AP. So, it is of great importance to explore the interactions, effects and especially, clinical significance of INa with other ion channel currents. This study reviewed the interaction of INa with other cardiac currents, and elucidated the mechanism of cardiac arrhythmias from the perspective of ion flow interaction. 【Key words】 sodium current; ion channel currents; action potentials; arrhythmias, cardiac This work was supported by the National Natural Science Foundation of China . Corresponding author: LI Yang, E-mail: liyangbsh@163.com 心脏电活动是多种离子流共同作用的结果：维持静息电位的钠-钙交换体电流（sodium-calcium exchanger current，INCX）、内向整流钾电流（inward rectifier potassium current，IK1）等；参与0相除极的L-型钙电流（L-type calcium current，ICa,L）、快失活钠电流（rapidly inactivating sodium current，INa,peak）；参与复极的快速激活延迟整流钾电流（rapidly activated delayed rectifier potassium current，IKr）、慢速激活延迟整流钾电流（slowly activated delayed rectifier potassium current，IKs）、瞬时外向钾电流（transient outward potassium current，Ito）、IK1、ICa,L、晚钠电流（late sodium current，INa,Late）；参与4相自动除极的起搏电流（funny current，If）、T-型钙电流（T-type calcium current，ICa，T）、IK1、乙酰胆碱激活钾电流（acetylcholine activated potassium current，I