伊布利特与胺碘酮联合应用对兔心肌电生理的影响

Effects of combined use of amiodarone and Ibutilide on cardiac electrophysiology in rabbit

【目的】观察伊布利特与胺碘酮联合使用后对兔跨室壁复极离散度的影响,为临床上合理使用伊布利特,提高药物安全性提供理论依据。【方法】新西兰大白兔40只,随机分为正常组、伊布利特组、胺碘酮组、伊布利特+胺碘酮组,每组10只。采用冠脉灌注左室楔形心肌组织块模型,在不同灌注溶液条件下,记录各组兔心室肌内膜及外膜动作电位时程(action potential duration,APD)及跨室壁复极离散(transmural dispersion of repolarization,TDR)。【结果】伊布利特组与对照组相比,心肌内膜、外膜细胞APD均延长,TDR也显著增大(P<0.05)。胺碘酮组与对照组相比,心肌内膜、外膜细胞APD延长(P<0.05),而TDR减小(P<0.05)。伊布利特+胺碘酮组与对照组、胺碘酮组、伊布利特组相比,心肌内膜、细胞APD均有延长(P<0.05)。伊布利特与胺碘酮合用后,TDR虽较胺碘酮组有所增大,但较伊布利特组减小,且与对照组无明显差异(P>0.05)。【结论】胺碘酮与伊布利特联合使用,有效减少单独使用伊布利特所引起的TDR增大,从而提高伊布利特临床使用的安全性。

【Objective】To investigate the effects of combined use of amiodarone and Ibutilide on transmural dispersion of repolarization（TDR）in rabbits,for providing experimental evidence to rational administration and drug safty.【Methods】40 New Zealand rabbits were randomly divided into control group（n = 10）,Ibutilide group（n = 10）,Amiodarone group（n = 10）,and Ibutilide ＋ Amiodarone group（n = 10）.Arterially perfused rabbit left ventricular wedge preparations were used to record the transmural ECG and transmembranous action potentials（APD） in different perfusion conditions.【Results】（1）Compared with control group,APDs of epicardium and endocardium increased in Ibutilide group were increased,so was the TDR.P values all have significant difference（P 0.05）.（2）Compared with control group,APDs of epicardium and endocardium in Amiodarone group were also increased（P 0.05）,but the TDR was decreased significantly（P 0.05）.（3）APDs of epicardium and endocardium in Ibutilide ＋ Amiodarone group were prolonged as compared with other three groups.Although the TDR in Ibutilide ＋ Amiodarone group was increased as compared with Amiodarone group,it had no significant difference as compared with control group（P 0.05）,and even decreased as compared with Ibutilide group（P 0.05）.【Conclusion】Combined use of amiodarone and ibutilide can reduce the TDR as compared with use of ibutilide alone,and improve the security of ibutilide clinical usage.