文章摘要
七氟醚对大鼠离体心脏全心缺血-再灌注心律失常及电生理的影响
Effects of sevoflurane on arrhythmia and electrophysiology during the global ischemia-reperfusion in isolated rat hearts
  
DOI：10.12089/jca.2018.12.019
中文关键词: 七氟醚  全心缺血-再灌注  心律失常  电生理
英文关键词: Sevoflurane  The global ischemia-reperfusion  Arrhythmia  Electrophysiology
基金项目:贵州省卫生计生委科学技术基金(gzwjkj2016-1-007)
作者单位E-mail
王贵龙 550004,贵阳市,贵州医科大学麻醉学院  
高鸿 贵州医科大学附属医院麻醉科 2169617@qq.com 
王子君 550004,贵阳市,贵州医科大学麻醉学院  
李伟超 550004,贵阳市,贵州医科大学麻醉学院  
李华宇 550004,贵阳市,贵州医科大学麻醉学院  
代东君 550004,贵阳市,贵州医科大学麻醉学院  
符校魁 550004,贵阳市,贵州医科大学麻醉学院  
刘艳秋 贵州医科大学附属医院麻醉科  
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中文摘要:
      
目的 观察七氟醚对大鼠离体心脏全心缺血-再灌注心律失常及电生理的影响。
方法 健康成年雄性SD大鼠,体重280～320 g，取成功制备Langendorff心脏灌注模型24个,K-H液灌注15 min后,随机分为三组,每组8只。对照组(C组):K-H液继续灌注105 min;全心缺血-再灌注组(IR组):K-H液继续灌注15 min后,注射Thomas液(4 ℃,20 ml/kg)使心脏停跳60 min,在心脏周围用低温(4 ℃)Thomas液保护,30 min时半量复灌Thomas液(4 ℃,10 ml/kg),停灌60 min时再灌注K-H液30 min;七氟醚组(Sev组):K-H液含饱和1.0 MAC的七氟醚,余同IR组。记录再灌注期间心律失常发生情况、心脏复跳时间及心律失常持续时间；记录平衡灌注15 min(T0)、继续灌注15 min(T1)、再灌注15 min/继续灌注105 min(T2)、再灌注30 min/继续灌注120 min（T3）的HR及左心室前壁外膜层和内膜层心肌单相动作电位；计算单相动作电位复极50％及90％的时程(MAPD50和MAPD90)、跨室壁复极离散度(TDR)。
结果 与T0时比较,T2、T3时IR组HR明显减慢(P<0.05)；与T1时比较,T2、T3时IR组HR均明显减慢(P<0.05)；与IR组比较,T2、T3时Sev组HR明显增快(P<0.05);与IR组比较,T2、T3时Sev组MAPD90明显缩短,TDR明显减小(P<0.05);与IR组比较,Sev组心脏复跳时间和心律失常持续时间均明显缩短(P<0.05)。
结论 七氟醚可缩短全心缺血-再灌注心脏MAPD90、减小TDR,从而降低再灌注心律失常的发生风险、缩短心脏复跳和心律失常持续时间。
英文摘要:
      
Objective To study the Effects of sevoflurane on arrhythmia and electrophysiology during the global ischemia-reperfusion in isolated rat hearts.
Methods Twenty-four healthy SD male rats, weighing 280 - 320 g, were randomly divided into three groups after successful preparation of langendorff isolated heart perfusion model and 15 min perfusion and balance of K-H fluid. In the control group (group C), K-H fluid was continuous perfusion for 105 min. In the ischemia - reperfusion group (group IR), K-H fluid was stopped after continuous perfused and balance for 15 min and cardiac arrest was induced for 60 min with the injection of Thomas solution (4 ℃, 20 ml/kg) while the heart was protected in a low temperature Thomas solution (4 ℃) around it. Reperfusion of Thomas solution (4 ℃, 10 ml/kg) was performed for 30 min and the heart was resuscitated by the perfusion of K-H fluid for 60 min. Sevoflurane group (group Sev), K-H fluid contained 1.0 MAC sevoflurane and other procedures were the same as in group IR. The development of arrhythmia, time for restoration of spontaneous heart beat and duration of arrhythmia were recorded during the period of reperfusion. HR, MAPS including time course (MAPD50 or MAPD90) of endocardium and epicardium was recorded at the time of balance perfusion for 15 min (T0), continuous perfusion for 15 min (T1), reperfusion for 15 min/continuous perfusion for 105 min (T2) and reperfusion for 30 min/continuous perfusion for 120 min (T3), transmural dispersion of repolarization (TDR) was calculated.
Results Compared with T0 and T1, HR in group IR was slower at T2 and T3(P < 0.05); compared with group IR at T2 and T3, HR in group Sev was higher (P < 0.05); compared with group IR at T2 and T3, MAPD90 in group Sev was shorter, and TDR in group Sev was decreased (P < 0.05); compared with group IR, time for restoration of spontaneous heart beat and duration of arrhythmia were shorter in group Sev (P < 0.05).
Conclusion Sevoflurane can decrease MAPD90 and TDR, and thendecrease the risk of arrhythmias, shorten the time for restoration of spontaneous heart beat and duration of arrhythmia.
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