本文關(guān)鍵詞：刺激左右頸部迷走交感干對兔心房與心室電生理特性的影響　出處：《山東大學(xué)》2008年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 頸迷走交感干 有效不應(yīng)期 心房纖顫 心房易損窗口 Q-T間期離散度 室顫閾值

【摘要】： 研究目的:本研究旨在通過給予兔左右頸部迷走交感干不同強度的電刺激,測量反映心房肌和心室肌電生理特性變化的相關(guān)指標(biāo),從而探討心臟外在自主神經(jīng)對心臟電生理特性的影響及其在心律失常發(fā)生中的可能作用。 研究方法:新西蘭大白兔10只,靜脈麻醉后,連接并記錄體表心電圖,分離右側(cè)頸靜脈,將6F四極電極導(dǎo)管經(jīng)上腔靜脈先后插入右心房、右心室,給予設(shè)定的電程序刺激,記錄心房有效不應(yīng)期(AERP)、P波離散度(PD)、發(fā)生心房纖顫(AF)的動物比例數(shù)、心房易損窗口(WOV)、心室有效不應(yīng)期(VERP)、Q-T間期離散度(Q-Td)、Tpeak-Tend(Tp-e)離散度、室顫閾值(VFT),再分離并暴露雙側(cè)頸部迷走交感干,植入刺激電極,并與高頻電刺激儀連接,分別給予左右單側(cè)及雙側(cè)迷走交感干電刺激,使心率較基礎(chǔ)狀態(tài)分別減慢10%、30%、50%,重復(fù)上述電刺激,并測量上述電生理指標(biāo)。 結(jié)果:①隨著刺激左側(cè)頸迷走交感干強度的增加,與基礎(chǔ)狀態(tài)相比較,AERP逐漸縮短,至刺激強度使心率減慢50%時,AERP縮短有統(tǒng)計學(xué)意義(71.5±12.39vs 99.0±21.55,P＜0.01);PD隨刺激強度的增加呈逐漸增大趨勢,至刺激強度使心率減慢50%時,PD與基礎(chǔ)狀態(tài)相比明顯增大(48.8±17.05 Vs 30.6±9.34,P＜0.05);發(fā)生AF的動物比例數(shù)及WOV雖分別有增多和增寬趨勢,但均無統(tǒng)計學(xué)意義。 ②隨著刺激右側(cè)頸迷走交感干強度的增加,與基礎(chǔ)狀態(tài)時比較,AERP逐漸縮短,直至刺激強度使心率減慢30%時,AERP縮短有統(tǒng)計學(xué)意義(81.6±12.20 vs99.0±21.55,P＜0.05),且繼續(xù)增加刺激強度使心率減慢50%時,AERP較基礎(chǔ)狀態(tài)縮短更顯著(69.2±14.05 vs 99.0±21.55,P＜0.01);PD隨刺激強度的增加呈逐漸增大趨勢,至刺激強度使心率減慢30%時,PD與基礎(chǔ)狀態(tài)相比明顯增大(42.3±10.85 vs 30.6±9.34,P＜0.05),且刺激強度增加至使心率減慢50%時,PD較基礎(chǔ)狀態(tài)增大更顯著(55.5±13.99 vs 30.6±9.34,P＜0.01);發(fā)生AF的動物比例數(shù)及WOV雖分別有增多和增寬趨勢,但亦無統(tǒng)計學(xué)意義。 ③給予雙側(cè)頸迷走交感干刺激,當(dāng)刺激強度使心率減慢10%時,與基礎(chǔ)狀態(tài)比較,AERP即有縮短(82.0±15.35 vs 99.0±21.55,P＜0.05),當(dāng)刺激強度分別增至使心率減慢30%、50%時,AERP縮短更顯著(P＜0.01);與基礎(chǔ)狀態(tài)比較,PD則隨刺激強度的增加呈逐漸增大趨勢,至刺激強度使心率減慢30%時,PD明顯增大(55.0±14.79 vs 30.6±9.34,P＜0.05),且繼續(xù)增加刺激強度使心率減慢50%時,PD較基礎(chǔ)增大更明顯(64.4±18.45 vs 30.6±9.34,P＜0.01);發(fā)生AF的動物比例數(shù)雖有增多趨勢,但仍無統(tǒng)計學(xué)意義;而WOV隨著刺激強度的增加與基礎(chǔ)狀態(tài)比較呈增寬趨勢,至刺激強度使心率減慢50%時,WOV增寬有統(tǒng)計學(xué)意義(7.6±3.51 vs 3.4±1.52,P＜0.05)。 ④隨著刺激左側(cè)頸迷走交感干強度的增加,與基礎(chǔ)狀態(tài)相比較,VERP逐漸延長,至刺激強度使心率減慢50%時,VERP延長有統(tǒng)計學(xué)意義(209.8±40.09 vs173.7±43.00,P＜0.05);Q-Td隨刺激強度的增加呈逐漸增大趨勢,至刺激強度使心率減慢30%時,Q-Td與基礎(chǔ)狀態(tài)相比明顯增大(47.1±10.91 vs 35.6±5.36,P＜0.05),且繼續(xù)增加刺激強度使心率減慢50%時,Q-Td增大更顯著(54.59±14.38 vs 35.6±5.36,P＜0.01);Tp-e離散度隨刺激強度的增加呈逐漸增大趨勢,至刺激強度使心率減慢30%時,Tp-e離散度增大有統(tǒng)計學(xué)意義(29.9±10.62 vs 21.8±5.17,P＜0.05);然而隨刺激強度的增加,與基礎(chǔ)狀態(tài)比較室顫閾值無明顯變化。 ⑤隨著刺激右側(cè)頸迷走交感干強度的增加,與基礎(chǔ)狀態(tài)相比較,VERP逐漸延長,至刺激強度使心率減慢50%時,VERP延長有統(tǒng)計學(xué)意義(214.3±40.92 Vs173.7±43.00,P＜0.05);Q-Td隨刺激強度的增加呈逐漸增大趨勢,至刺激強度使心率減慢30%時,Q-Td與基礎(chǔ)狀態(tài)相比明顯增大(48.6±7.00 vs 35.6±5.36,P＜0.05),且刺激強度繼續(xù)增加至使心率減慢50%時,Q-Td增大更顯著(56.2±14.34 vs 35.6±5.36,P＜0.01);隨刺激強度的增加Tp-e離散度逐漸增大,至刺激強度使心率減慢30%時,Tp-e離散度增大有統(tǒng)計學(xué)意義(32.8±9.91 vs21.8±5.17,P＜0.01);然而隨刺激強度的增加,與基礎(chǔ)狀態(tài)比較室顫閾值無明顯變化。 ⑥隨著刺激雙側(cè)頸迷走交感干強度的增加,與基礎(chǔ)狀態(tài)相比較,VERP逐漸延長,至刺激強度使心率減慢30%時,VERP延長有統(tǒng)計學(xué)意義(210.6±40.35 vs173.7±43.00,P＜0.05);當(dāng)刺激強度使心率減慢10%時,Q-Td與基礎(chǔ)狀態(tài)相比明顯增大(44.2±6.10 vs 35.6±5.36,P＜0.05),隨刺激強度的增加Q-Td進一步增大,至心率減慢50%時,Q-Td增大更顯著(62.8±16.36 vs 35.6±5.36,P＜0.01);Tp-e離散度隨刺激強度的增加逐漸增大,至刺激強度使心率減慢30%時,Tp-e離散度增大有統(tǒng)計學(xué)意義(32.5±9.19 vs 21.8±5.17,P＜0.01);然而隨刺激強度的增加,與基礎(chǔ)狀態(tài)比較,室顫閾值雖有逐漸減小的趨勢,但無統(tǒng)計學(xué)意義。 結(jié)論:①右心房電生理特性受雙側(cè)頸迷走交感干的影響,且以右側(cè)為優(yōu)勢,其中左右頸迷走交感干對右心房電生理特性的影響存在疊加作用;右心室電生理特性受雙側(cè)頸迷走交感干的影響,左右側(cè)無差異,但左右頸迷走交感干對右心室電生理特性的影響存在疊加作用。②心臟外在自主神經(jīng)在心房電生理特性變化中起重要作用,并可能參與房性心律失常的發(fā)生;心臟外在自主神經(jīng)在心室電生理特性變化中亦起重要作用,可能是室性心律失常發(fā)生的潛在因素。
[Abstract]:Objective: This study aims to give the rabbit left and right cervical Vagosympathetic trunk electrical stimulation of different intensity measurements, changes of physiological characteristics of atrial and ventricular myocardium of heart, so as to explore the external effect of autonomic nerve on cardiac electrophysiology and arrhythmia in May.
Methods: 10 New Zealand rabbits were anesthetized, connected and recorded electrocardiogram, right jugular vein, 6F quadrupole electrode catheter via superior vena cava were inserted into the right atrium, right ventricle, set the programmed electrical stimulation, recording the atrial effective refractory period (AERP), P wave dispersion (PD), atrial fibrillation (AF) in the proportion of the number of animal vulnerable window (WOV), atrial, ventricular effective refractory period (VERP), Q-T dispersion (Q-Td), Tpeak-Tend (Tp-e) dispersion and ventricular fibrillation threshold (VFT), then separated and exposed double lateral cervical Vagosympathetic trunk. Implantation of stimulating electrodes, and high frequency electrical stimulation instrument connection, were given about unilateral and bilateral Vagosympathetic trunk stimulation, the heart rate compared to the basic state respectively decreased 10%, 30%, 50%, repeat the above electrical stimulation, and measuring the electrophysiological index.
Results: with the stimulation of the left cervical vagal intensity increased the sympathetic trunk, compared with the basic state, AERP gradually reduced to the stimulus intensity decreased heart rate 50%, AERP shortening was statistically significant (71.5 + 99 12.39vs + 21.55, P < 0.01 PD); with the increase of stimulus intensity increase gradually, to the stimulus intensity decreased heart rate of 50%, compared with the basic state of PD increased significantly (48.8 + 17.05 Vs 30.6 + 9.34, P < 0.05); AF and WOV respectively, although the proportion of animal has increased and widened trend, but no statistical significance.
The right cervical vagal stimulation with increasing intensity of the sympathetic trunk, compared with the baseline, AERP decreased gradually, until 30% when the stimulus intensity decreased heart rate, shortening of AERP was statistically significant (81.6 + 12.20 vs99.0 + 21.55, P < 0.05), and continue to increase the intensity of stimulation make the heart rate of 50%, compared with the basic AERP shorten the state more significant (69.2 + 14.05 vs 99 + 21.55, P < 0.01 PD); with the increase of stimulus intensity increase gradually, to stimulate strength make the heart rate of 30%, compared with the basic state of PD increased significantly (42.3 + 10.85 vs 30.6 + 9.34, P < 0.05), and the stimulus intensity increased to the heart rate of 50%, PD was more significantly increased state (55.5 + 13.99 vs 30.6 + 9.34, P < 0.01); AF and WOV respectively, although the proportion of animal has increased and widened trend, but it has no statistical significance.
鈶㈢粰浜堝弻渚ч榪瘋蛋浜ゆ劅騫插埡嬋，

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