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|本期目录/Table of Contents|

刺激左右颈部迷走交感干对兔心房电生理特性的影响

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2010年第2期
页码:
176-179,182
栏目:
基础研究
出版日期:
2010-03-04

文章信息/Info

Title:
Effects of electrical stimulation of left and right cervical vagosympathetic trunks on electrophysiological characteristics of right atrium in rabbits
作者:
刘蔚1; 高梅2; 王奖荣2; 孙慧2; 贾晓萌2; 侯应龙2
山东大学附属千佛山医院：1.超声科，2.心内科，山东 济南 250014
Author(s):
LIU Wei1;  GAO Mei2;  WANG Jiang-rong2;  SUN Hui2;  JIA Xiao-meng2;  HOU Ying-long2
1.Department of Cardiovascular Medicine, 2.Department of Ultrasongraphy, Qianfoshan Hospital Affiliated to Shandong University, Jinan 250014, Shandong, China
关键词:
颈迷走交感干; 有效不应期; 心房纤颤; 心房易损窗口; 兔
Keywords:
cervical vagosympathetic trunk;  effective refractory period;  atrial fibrillation;  windows of atrial vulnerability;  rabbit
分类号:
R331.38
DOI:
-
文献标识码:
A
摘要:
目的: 探讨心脏外在自主神经对心房电生理特性的影响及其在房性心律失常发生中的可能作用。方法: 新西兰大白兔10只静脉麻醉后，经右侧颈静脉将6F电极导管置入右心房，并给予设定的电程序刺激，记录心房有效不应期（AERP）、P波离散度（PD）、发生心房纤颤（AF）动物的比例数及心房易损窗口（WOV），再分别给予左右单侧及双侧颈迷走交感干(CVST)电刺激，使心率(HR)较基础状态分别减慢10%、30%和50%，重复上述电刺激，并测量上述电生理指标。将10只新西兰大白兔颈部迷走交感干刺激前后所测指标先后对照。结果: 随着刺激CVST强度的增加，与基础状态相比较，AERP逐渐缩短，至刺激强度使HR减慢10%（双侧）、30%（右侧）和50%（左侧）时，AERP缩短具有统计学意义（P<0.05）；PD随刺激强度的增加呈逐渐增大的趋势，至刺激强度使HR减慢30%（右侧、双侧）、50%（左侧）时，与基础状态相比PD明显增大（P<0.05）。以上两个指标随着刺激强度的增加，变化均更显著（P<0.01）。无论给予实验设定的任何强度的左、右单侧或是双侧CVST刺激，发生AF的动物的比例数均有增多的趋势，但无统计学意义；仅在进行双侧CVST刺激并当强度达到使HR较基础减慢50%时，WOV增宽才具有统计学意义［(7.6±3.5)ms vs. (3.4±1.5)ms，P<0.05］。结论: 右心房的电生理特性受双侧CVST的影响，且以右侧为优势，其中左右CVST对右心房电生理特性的影响存在叠加作用。
Abstract:
AIM: To investigate the electrophysiological effects of extrinsic autonomic nerves on the atrium by stimulating rabbit cervical vagosympathetic trunk (CVST) using different electrical intensities. METHODS: Ten New Zealand rabbits were anesthetized. A 6F electrical catheter was inserted into the right cardiac atrium through right jugular vein. The atrial effective refractory period (AERP), P-wave dispersion (PD), the number of rabbits with atrial fibrillation (AF) and the window of atrial vulnerability (WOV) were measured and recorded by programmed electrical stimulation (PES). Bilateral CVSTs were then disassociated, exposed and stimulated by different intensities to reduce the heart rate (HR) by 10%, 30% and 50%, respectively. The same PES was given and the same indexes were recorded. RESULTS: Compared with the baseline, the shortening of AERP was significant (P<0.05) when the intensity of stimulating left CVST was increased to reduce the heart rate by 50% or that of stimulating right CVST was increased to reduce the HR by 30%, or that of bilateral CVST was increased to reduce the HR by 10%. A significant change in PD was also observed (P<0.05) when the intensity of stimulating left CVST was increased to reduce the HR by 50% or that of stimulating right and bilateral CVST to reduce the HR by 30%. More remarkable changes were observed with the increasing stimulating intensity (P<0.01). However, no significant difference was observed in the number of rabbits with AF between stimulating right, left or bilateral CVST or between different stimulating intensities. Only when the intensity of stimulating bilateral CVSTs was increased to reduce the HR by 50%, the widening of WOV was significant ［from (3.4±1.5) msec to (7.6±3.5) msec; P<0.05］. CONCLUSION: Electrophysiological characteristics of the right atrium are influenced by bilateral CVSTs where the effect of right CVST is predominant. There is a coordinating effect of both CVSTs on the electrophysiologic characteristics of the right atrium.

参考文献/References

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备注/Memo

备注/Memo:
收稿日期：2009-3-10.通讯作者：侯应龙，主任医师，主要从事心律失常的射频消融术和冠心病的诊治研究Email：houyinglong@sina.com 作者简介：刘蔚，住院医师，硕士Email：liuwei-joan@sohu.com
更新日期/Last Update: 2010-03-05