消旋去甲乌药碱对窦房结功能电生理的影响

Effects of higenamine on electrophysiology of sinus node

目的 :探讨消旋去甲乌药碱治疗病态窦房结综合征的作用机制。方法 :4 0只杂种家兔随机分为窦房结功能正常组和窦房结功能受损 (SND)组 ,每组随机分为用药组和对照组 (n=10 )。采用甲醛溶液湿敷窦房结的方法制备 SND模型。用药组 5 min内经耳缘静脉注入消旋去甲乌药碱 0 .0 4 mg/ kg,2 0 m in后测定用药前、后窦房结功能电生理指标——窦房结恢复时间 (SNRT)、纠正窦房结恢复时间 (CSNRT)、总窦房传导时间(TSACT)和窦性心律周期 (SCL)的变化 ;正常组用生理盐水 10 ml作对照用药。结果 :1窦房结功能正常组和SND组在给予消旋去甲乌药碱后 ,SNRT、CSNRT、TSACT和 SCL 均较对照组明显缩短 (P<0 .0 5或 P<0 .0 1)。 2消旋去甲乌药碱对 SND组窦房结功能电生理影响明显大于窦房结功能正常组 (P均 <0 .0 1) ;对窦房结功能受损引起的心律失常治疗作用有统计学意义 (P<0 .0 5 )。结论 :窦房结自律性的提高及窦房、房室传导功能改善是消旋去甲乌药碱治疗病态窦房结综合征主要的电生理机制。

Objective: To investigate the mechani sm of higenamine in treatment of sick sinus syndrome. Methods: Forty adult mongrel rabbits were enrolled, and were randomly divided into two grou ps: normal sinus node group and damaged sinus node group. Sinus node was soaked with 36% formalin to produce the experimental model of damaged sinus node. E ach group was divided into two subgroups: treatment group and control group(n=10 in each group). The rabbits in the two treatment groups were treated with intravenous higenamine fluid 004 mg/kg within 5 minutes. The rabbits in the two control groups were treated with 10 ml of 09% NaCl intravenous injection. After 20 minutes, the chan ges of sinus node recovery time(SNRT), corrected SNRT(CSNRT), total sino atrial conduction time (TSACT) and sinus cycle length(SCL) were recorded i n all rabbits before and after treatment. Results: ①SNRT, CSNRT, TSACT and SCL were shortened after higenamine treatment in bo th normal and damaged sinus node groups(P<005 or P<001). ②The change s of SNRT, CSNRT and TSACT were more remarkable in rabbits with damaged sinus n ode than those in rabbits with normal sinus node after administration of higenam ine injection(all P<001). ③The therapeutic effects of higena min e on arrhythmia induced by sinus node damage were significant(P<005). Conclusion: Accelerating recovery of sinus node automaticity and i mprove sinoatrial and atrialventricular conduction is th e main electrophysiological mechanism of higenamine in treatment of sick sinus syndro me.