rhTNFR:Fc对离体大鼠心脏心肌梗死后快速室性心律失常的影响

Effects of rhTNF:Fc on ventricular arrhythmia induced by AMI

目的:观察重组人肿瘤坏死因子受体融合蛋白(rhTNFR:Fc)对体外大鼠心脏急性缺血梗死后快速室性心律失常发生的影响,进一步探讨心肌急性缺血后心律失常机制及TNF-α在其中的作用。方法:将45只雄性大鼠随机分为3组,分别为对照组、急性心肌梗死组、急性心肌梗死加rhTNF:Fc组。Langenoff灌流大鼠体外心脏,结扎后2组大鼠的左前降支冠状动脉,记录心脏表面心电图,急性缺血0.5h后给予S1S2程序电刺激诱发室性心动过速或心室颤动,比较各个组间发生率的差异。结果:急性心肌梗死组出现室性心律失常的发生率明显高于对照组,差异有统计学意义(P<0.01)。急性心肌梗死加rhTNF:Fc组与急性心肌梗死组相比,心室颤动或室性心动过速发生率显著降低(P<0.01)。对照组与急性心肌梗死加rhTNF:Fc组差异无统计学意义。结论:特异性肿瘤坏死因子拮抗剂rhTNF:Fc能降低体外大鼠心脏急性心肌梗死后恶性心律失常的发生率。

Objective：To make further study on the mechanisms of ventricular arrhythmia induced by acute ischemia of myocardial tissues, and the roles played by TNF-α during the process. We＇ve observed the effects of rhTNF：Fc on ventricular tachyarrhythmias after acute myocardial infarction （AMI） in isolated perfusing rat hearts. Method：The total of 45 male Wistar rats were randomly divided into three groups：control group （n= 15）, AMI group （n= 15） and AMI＋ rhTNF：Fc group （n= 15）. The AMI on the isolated rat hearts was induced by left anterior descending coronary branch ligation. ECG was recorded, and sls2 programmed electrical stimulation was imposed on the isolated hearts half an hour after AMI to induce ventricular arrhythmia（VT/VF）. Observe the in cidence of every group. Result：Compared with the control, the incidence of ventricular arrhythmia has significantly increased in the group with AMI（P〈0.01）. In addition, among the rats with infarction, the incidence has been significantly decreased in thoses interfered with rhTNF： Fc（P〈0.01）, which has no significant difference with that in control. Conclusion： The special antagonist of TNF-α（rhTNF： Fc） could reduce the incidence of malignant arrhythmia after AMI in the solated perfusing rat heart.