评价抗快速室性心律失常药物的心电生理—电药理学方法

评价抗快速室性心律失常药物的心电生理—电药理学方法

郭治彬, 李青, 曹宏宇, 徐智

江西医学院第一附属医院心血管内科, 南昌 330006

收稿日期:2001-09-10 修回日期:2002-01-20 出版日期:2002-03-15 发布日期:2002-03-15

Electrophysiologic-electropharmacologic Method for Evaluating the Effects of Antagonizing Ventricular Tachyarrhythmic Drugs

Guo Zhibin, Li Qing, Cao Hongyu, Xu Zhi

Department of Cardiovascular Disease, First Affiliated Hospital of Jiangxi Medical College, Nanchang 330006

Received:2001-09-10 Revised:2002-01-20 Online:2002-03-15 Published:2002-03-15

摘要/Abstract

摘要： 用冠状动脉Harris二期结扎并部分再灌注及吻合支缝扎法造成犬急性心肌梗塞, 5-8天后, 辅以心脏程控刺激技术(PES) 进行心电生理检查及复制快速室性心律失常, 研制成犬在体心脏心电生理—电药理学实验模型, 并观察了普鲁卡因胺(PA)对该实验模型的电生理影响。结果表明, PA能显著延长QTc间期、RERP、NERP及IERP , 缩小IDR和VDR , 抑制心室PES诱发的室速和室颤, 并能有效地预防犬心肌梗塞后再次急性缺血所导致的自发性室颤, 表明PA有抗缺血性快速室性心律失常的心电生理—电药理作用。结果同时表明, 该心电生理—电药理学实验的犬模型具有很高的可靠性、重复性及临床相关性, 是一种有价值的评价抗快速室性心律失常药物的心电生理—电药理学方法.

关键词: 普鲁卡因胺, 心律失常, 心电生理学, 心肌梗塞, 心肌缺血

Abstract: Objective To establish a canine model of electrophysiologic-electropharmacology as assessed by programmed electrical stimulation (PES), and to observe the electrophysiologic effects of Procainamide(PA) on normal and ischemic myocardium in case of ischemic ventricular tachyarrhythmia in this model. Methods A ishemic ventricular tachyarrhythmias canine model was established in open-chest dogs subjected to programmed electrical stimulation(PES)for 5-8 days after acute myocardial infarction. The electrophysiologic effects of procainamide were observed in this model. With routine methods of PES,ventricular tachycardia(VT) and ventricular fibrillation (VF) could be reproducibly initiated. Results Procainamide distinctly lengthened the QTc interval (P<0.01) and effective refractory period (ERP) of normal and ischemic ventricular myocardium (NERP and IERP) respectively (P<0.01), decreased the dispersion of ERP in ischemic myocardium and the dispersion of ERP in left ventricle (P<0.01), and increased the diastolic excitability threshold of normal and ischemic ventricular myocardium remarkably (P<0.01). Procainamide effectively prevented the PES-induced VT or VF (P<0.05) and ischemia-induced VF (P<0.05). Conclusion The results indicated that PES-induced VT/VF were highly reproducible and reliable, this canine model is a worthy and reliable one, procainamide may be effective in preventing the onset of VT and VF after myocardial ischemic damage, and deserves further attention as an antifibrillatory agent.

Key words: Procainamide, Procainamide, Arrhythmia, Arrhythmia, Ischemic, Ischemic, Electrophysiology, Electrophysiology, Myocardial infarction, Myocardial infarction

Supporting:

郭治彬, 李青, 曹宏宇, 徐智. 评价抗快速室性心律失常药物的心电生理—电药理学方法[J]. .

Guo Zhibin, Li Qing, Cao Hongyu, Xu Zhi . Electrophysiologic-electropharmacologic Method for Evaluating the Effects of Antagonizing Ventricular Tachyarrhythmic Drugs[J]. .

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