犬冠状静脉窦阻塞对心电图影响.docVIP

犬冠状静脉窦阻塞对心电图影响 　　[摘要] 目的 探讨冠状静脉窦阻塞对心电图的影响。 方法 自2014年5月―2014年10月取犬14只，随机分为实验组7只和对照组7只。开胸，应用无损伤滑线从心外膜在最接近冠状静脉窦口处结扎阻塞冠状静脉窦，对照组不对冠状静脉窦结扎。 结果 实验组冠状静脉窦阻塞后当即Ⅱ、Ⅲ、aVF导联出现ST段抬高0.05 mV，偶有aVR导联ST段压低；阻塞30 min ST段恢复到基线水平；60 min ST段出现压低约0.05 mV，偶见aVL导联ST-T改变；阻塞120 min ST段又恢复到基线水平，偶见短暂Q波。有一例在结扎约40 min时，QT间期出现突然延长，然后出现室性心动过速。对照组未见明显变化（P0.05）。 结论 冠状静脉窦阻塞可导致心电图肢体导联呈ST-T改变。 　　[关键词] 冠状静脉窦阻塞；心电图；ST-T改变 　　[中图分类号] R5 [文献标识码] A [文章编号] 1674-0742（2016）02（b）-0185-03 　　[Abstract] Objective To discuss the effect of coronary sinus occlusion on electrocardiogram. Methods 14 dogs treated from May 2014 to October 2014 were selected and randomly divided into the experimental group and the control group with 7 dogs in each， after thoracotomy， the coronary sinus was occluded by ligation at the place closest to the coronary sinus orifice from epicardium by using scatheless slip line， the control group did not ligate coronary sinus. Results In the experimental group， ST segment elevation greater than 0.05 mV occurred to Ⅱ，Ⅲ，aVF leads as soon as the occlusion of coronary sinus， occasionally ST segment depression occurred to aVR lead， ST segment returned to baseline level after 30 minutes of occlusion， depression about 0.05 mV occurred to ST segment after 60 minutes of occlusion， occasionally ST-T changes occurred to aVL lead， ST segment returned to baseline level again after 120 minutes of occlusion， occasionally transient Q wave occurred， sudden extension of QT interval occurred at about 40 minutes of ligation in one case， then ventricular tachycardia occurred， and there was no obvious change in the control group（P0.05）. Conclusion Coronary sinus occlusion can lead to ST-T changes in ECG limb leads. 　　[Key words] Coronary sinus occlusion； Electrocardiogram； ST-T changes 　　心脏再同步化治疗在改善心力衰竭患者病情及预防心脏性猝死方面取得了显著的疗效，受到了人们越来越多的关注。而有关于冠状静脉系统的解剖影像学的信息陆续见诸报道[1]，另外由冠状静脉置入电极，所造成的医源性损伤亦有形成血栓和闭塞的危险[2]。心电图作为最常规的检测工具，在冠状静脉闭塞后会出现怎样的变化及其可能的机制值得探讨。在该研究中，自2014年5月―2014年10月选取14只犬，建立冠状静脉窦阻塞模型，分析其心电图变化情况，现报道如下。 　　1 资料与方法