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目的:观察门冬氨酸钾镁注射液对家兔缺血再灌注心肌室性心律失常的抑制作用并探讨其抗心律失常作用机制。方法:30只家兔随机分为正常组、心肌缺血组和治疗组,每组10只,制备兔左心室楔形心肌块。正常组持续灌流台氏液,心肌缺血组和治疗组灌流台氏液1h后停灌0.5h,造成心肌缺血,0.5h后复灌台氏液并程序刺激诱发心律失常,治疗组复灌的台氏液中含有浓度为2.42mg/L的门冬氨酸钾镁。采用浮置玻璃微电极法同步记录楔形心肌块内、外膜心肌细胞跨膜动作电位和跨壁心电图,观察正常组、心肌缺血组和治疗组再灌注0.5h的QT间期和内、外膜心肌细胞跨膜动作电位时程以及跨室壁复极离散度(TDR),记录正常组、心肌缺血组和治疗组缺血再灌注时室性心律失常的诱发率。结果:①心肌缺血组较正常组和治疗组TDR明显延长(P<0.05),治疗组与正常组相比,TDR差异无统计学意义(P>0.05)。②正常组无一例发生心律失常、心肌缺血组和治疗组室性心律失常的发生率分别为90%(9/10)、10%(1/10),心肌缺血组和治疗组间差异有统计学意义(P<0.05)。结论:门冬氨酸钾镁可改善再灌注心肌的各项异常的电生理指标,特别是减小TDR,并能够明显降低再灌注心肌室性心律失常的发生率。
Objective: To observe the inhibitory effect of potassium-magnesium aspartate injection on ventricular arrhythmia induced by ischemia-reperfusion in rabbits and to explore its anti-arrhythmic mechanism. Methods: Thirty rabbits were randomly divided into normal group, myocardial ischemia group and treatment group, with 10 in each group. The rats in the normal group were continuously infused with Tyrodes solution, myocardial ischemia group and the rats in the treatment group were infused with Tyrode’s solution for 1 hour and then stopped for 0.5h, resulting in myocardial ischemia. After 0.5h, Tyrode’s solution was infused and programmed stimulation induced arrhythmia. Of Typhoid solution contains potassium magnesium aspartate at a concentration of 2.42 mg / L. Using floating glass microelectrode method, the transmembrane action potentials and transmyocardial electrocardiogram of cardiomyocytes in epicardial and adventitia of wedge-shaped myocardium were recorded synchronously, and the QT interval of 0.5 h and the inside and outside of reperfusion of normal group, myocardial ischemia group and treatment group were observed The transmembrane action potential duration and transmural repolarization dispersion (TDR) were recorded. The induction rate of ventricular arrhythmia during ischemia-reperfusion in normal group, myocardial ischemia group and treatment group was recorded. Results: ① The TDR in myocardial ischemia group was significantly longer than that in normal group and treatment group (P <0.05). There was no significant difference in TDR between treatment group and normal group (P> 0.05). The incidence of ventricular arrhythmia in the normal group was 90% (9/10), 10% (1/10) in the ischemic group and the untreated group, respectively. The difference between the myocardial ischemic group and the treated group There was statistical significance (P <0.05). Conclusion: Potassium and magnesium aspartate can improve various abnormal electrophysiological indexes of myocardial reperfusion, especially reduce TDR, and can significantly reduce the incidence of ventricular arrhythmia after reperfusion.