董丽,高鸿,刘艳秋,安丽,任益民,胡柏龙
DONG Li,GAO Hong,LIU Yanqiu,AN Li,REN Yimin,HU Bailong

• 1:贵州医科大学附院麻醉科

摘要(Abstract)：

目的:观察不同浓度异丙酚对家兔心肌细胞动作电位时程的影响。方法:成年家兔24只,制备Langendorff离体心脏灌注模型,K-H液灌注10 min后随机均分为对照组(C组)、低浓度异丙酚组(LP组)及高浓度异丙酚组(HP组),C组继续灌注K-H液60 min,LP和HP组分别灌注含4 mg/L与8 mg/L异丙酚的K-H液60 min;记录3组家兔平衡灌注10 min(T0)、继续灌注5 min(T1)、30 min(T2)、60 min(T3)时右心室前壁三层心肌动作电位,计算单相动作电位复极20%、50%、90%的时程(MAPD20、MAPD50、MAPD90)。结果:与T0比较,LP组和HP组T1~T3时MAPD20、MAPD50、MAPD90延长(P<0.05);与T1比较,两组T2~T3时MAPD20、MAPD50、MAPD90延长(P<0.05);与T2比较,两组T3时MAPD20、MAPD50、MAPD90延长(P<0.05);同一时点与C组和LP组比较,HP组T1~T3时MAPD20、MAPD50、MAPD90延长(P<0.05)。结论:丙泊酚灌注时间延长和高浓度丙泊酚灌注,可延长心肌细胞动作电位的复极过程,这可能是临床使用丙泊酚导致心律失常的机制之一。
Objective: To observe the effect of propofol on monophasic action potential duration( MAPD) of three-layer myocardium in isolated rabbit hearts. Methods: Twenty-four adult rabbits' isolated hearts were used to prepare Langendorff perfusion model. The hearts were randomly divided into 3 groups after perfusion with Krebs-Hensleit solution for 10 min: control group( group C),low concentration propofol group( group LP) and high concentration propofol group( group HP). Groups LP and HP were perfused with 4 mg / L and 8 mg / L of propofol Krebs-Hensleit solution for 60 min,respectively. Group C continued perfusion of Krebs-Hensleit solution for 60 min. The monophasic action potential of three-layer myocardium of right ventricular anterior wall was recorded at following time points: 10 min after balanced perfusion for( T0),5 min after continued perfusion( T1),30 min( T2) and 60 min( T3). The monophasic action potential duration of propofol at 20%( MAPD20),50%( MAPD50) and 90%( MAPD90) was calculated. Result: In groups LP and HP,MAPD20,MAPD50 and MAPD90at T2~ T3 were prolonged compared with their counterparts at T0( P < 0. 05). In groups LP and HP,MAPD20,MAPD50 and MAPD90at T2~ T3 were prolonged compared with their counterparts at T1( P < 0. 05). In groups LP and HP,MAPD20,MAPD50 and MAPD90at T3 were prolonged compared with their counterparts at T2( P < 0. 05). Compared with group C and Group LP,at the same time points in Group HP MAPD20,MAPD50 and MAPD90were prolonged( P < 0. 05). Conclusion: Prolonged propofol perfusion and high-dose propofol perfusion can prolong process of repolarization of monophasic action potential of myocardium cell,which may result in arrhythmias.

关键词(KeyWords)： 丙泊酚;单相动作电位时程;电生理学技术;家兔
propofol;monophonic action potential duration;electrophysiological techniques;rabbits

Abstract:

Keywords:

基金项目(Foundation): 贵州省科技厅联合基金项目(黔科合LG字2011015号)

作者(Author): 董丽,高鸿,刘艳秋,安丽,任益民,胡柏龙
DONG Li,GAO Hong,LIU Yanqiu,AN Li,REN Yimin,HU Bailong

DOI: 10.19367/j.cnki.1000-2707.2015.07.006

参考文献(References)：

• [1]Yatabe T,Hirohashi M,Takeuchi S,et al.Case of ventricular fibrillation in patients with brugada type electrocardiogram during surgery[J].Masui,2011(6):728-732.
• [2]周海英,周亚琼,邹丽君,等.丙泊酚过敏反应伴心律失常1例分析[J].中国误诊学杂志,2009(25):6281.
• [3]Tsutsumi YM,Tomiyama Y,Horikawa YT,et al.General anesthsia for electroconvulsive therapy with Brugada electrocardiograph pattern[J].J Med Invest,2011(3):273-276.
• [4]谷宇,高鸿,杨烨.异氟烷对心肌动作电位及缝隙连接蛋白Cx43的作用[J].贵阳医学院学报,2012(1):55-59.
• [5]Zeraatkar E,Kermani S,Mehridehnavi A,et al.Arrhythmia Detection based on Morphological and Time-frequency Features of T-wave in Electrocardiogram[J].J Med Signals Sens,2011(2):99-106.
• [6]Zhong Y,Cao P,Tong CF,et al.Effect of Ramipril on the Electrophysiological Characteristics of Ventricular Myocardium After Myocardial Infraction in Rabbits[J].Journal of Cardiovascular Medicine,2012(5):313-318.
• [7]Lee P,Klos M,Bollensdorff C,et al.Simultaneous voltage and calcium mapping of genetically purified human induced pluripotent stem cell-derived cardiac myocyte monolayers[J].Circ Res.2012(12):1556-1563.
• [8]Prystowsky EN,Padanilam BJ,Joshi S,et al.Ventricular arrhythmias in the absence of structural heart disease[J].J Am Coll Cardiol,2012(20):1733-1744.

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