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葡萄糖胰岛素钾极化液对犬重度心肌缺血/再灌注后心律失常和心电图的影响(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2005年第2期
页码:
99-101,105
栏目:
基础研究
出版日期:
2005-03-05

文章信息/Info

Title:
Effects of glucoseinsulinpotassium cocktail on ventricular arrhythmias and electrocardiogram in a canine model of myocardial ischaemia and reperfusion
作者:
董玲1; 霍建华1; 梁少君1;  张航向3; 王跃民1; 张晓东1; 臧益民1; 高峰1
第四军医大学：1.基础部生理学教研室，2.唐都医院麻醉科，3.西京医院老年病科，陕西 西安 710032
Author(s):
DONG Ling1;  HUO Jianhua1;  LIANG Shaojun2;  ZHANG Hangxiang3;  WANG Yuemin1;  ZHANG Xiaodong1;  ZANG Yimin1;  GAO Feng1
1. Department of Physiology, Faculty of Preclinical Medicine, 2. Department of Anesthesia, Tangdu Hospital, 3.Department of Geriatrics, Xijing Hospital, Fourth Military Medical University, Xi'an,Shaanxi 710032, China
关键词:
葡萄糖胰岛素钾;  心肌缺血/再灌注;  心律失常;  狗
Keywords:
glucose-insulin-potassium;  myocardial ischemia/reperfusion;  arrhythmia;  dogs
分类号:
R541.7
DOI:
-
文献标识码:
A
摘要:
目的 探讨葡萄糖-胰岛素-钾合剂（GIK）对犬重度心肌缺血/再灌注（MI/R）后心律失常和心电图的影响。方法 制备犬重度MI/R模型。 再灌注前 5 min静脉分别输注生理盐水、GIK或GK（葡萄糖-钾液）。观察动物心电、血糖等的变化。结果 犬重度MI/R引起心律失常，包括室性早搏、室速和室颤。再灌注期间静脉输注生理盐水、GIK或GK，未观察到室性心律失常发生率和严重程度有显著差异。但GIK可缩短再灌注期间心电图QRS波群时间。其中，再灌注4 h QRS波群时间显著缩短，由对照组0.077±0.006 s 缩短至GIK组0.058±0.003 s（n=6,P<0.01）。GK组与对照组比较无显著差异（n=6,P>0.05）。结论 GIK对犬重度MI/R引起的室性心律失常无显著改善作用，但可缩短缺血/再灌注心脏的QRS波群时间，提示胰岛素可能影响 MI/R心室除极。
Abstract:
AIM To study the effects of glucoseinsulinpotassium (GIK) cocktail on ventricular arrhythmias induced by severe myocardial ischemia (MI)/reperfusion (R) in anesthetized dogs. METHODS Mongrel dogs of both sexes were subjected to 50 min MI (coronary blood flow reduced by 80%) and then to R for 4 h. Eighteen mongrel dogs randomly received continuous infusions of saline, GIK or GK (n=6 /per group), beginning 5 min before R and continuing throughout the 4 h R. Conventional Lead Ⅱ ECG was monitored throughout the experiment. RESULTS Compared with vehicle, GIK significantly shortened QRS duration at R at 4 h (0.058±0.003 s vs saline 0.077±0.006 s, n=6, P<0.01), whereas GKtreated dogs did not show significant difference compared with that of saline group (n=6, P>0.05). Treatments with neither GIK nor GK significantly suppressed the ventricular arrhythmias following MI/R. CONCLUSION The above results suggest that GIK can shorten QRS duration of ventricular arrhythmias induced by MI/R and that insulin, rather than GK, may affect the ventricular depolarization during MI/R.

参考文献/References

［1］ 高峰，施东伟，王小明，等. 葡萄糖-胰岛素-钾（极化液）对缺血/再灌大鼠心肌细胞死亡及心脏功能的影响：胰岛素的关键作用［J］.中华内科杂志,2003,42(3): 148-152.

［2］Ulgen MS,Alan S,Akdemir O,et al. The effect of glucoseinsulinpotassium solution on ventricular late potentials and heart rate variability in acute myocardial infarction［J］. Coron Artery Dis, 2001,12(6):507-512.

［3］Aulbach F, Simm A, Maier S, et al. Insulin stimulates the L-type Ca2+ current in rat cardiac myocytes［J］. Cardiovasc Res, 1999, 42:113-120.

［4］Shimoni Y,Ewart HS,Severson D. Insulin stimulation of rat ventricular K+ currents depends on the integrity of the cytoskeleton［J］. J Physiol, 1999,514 ( Pt 3):735-745.

备注/Memo

备注/Memo:
收稿日期：2004-04-28.基金项目：国家自然科学基金资助项目（No.30370525,No.30471923）
更新日期/Last Update: 2010-01-05