急性肾损伤期间自然状态心率及室性心律失常特性的观察

Observation of natural heart rate and characteristics of ventricular arrhythmias during acute kidney injury

目的建立5/6肾切除致慢性肾脏病大鼠模型,并探讨造模后5天内急性肾损伤(AKI)期自发性心率变化及室性心律失常情况和6周后心室电生理特征。方法选取SPF级雄性成年SD大鼠28只,适应性饲养1周后随机分为假手术组(Sham组)与AKI组,每组14只。AKI组大鼠切除右肾和2/3的左肾,取9只大鼠于造模术后佩戴人体贴片式TER010心电记录仪并连续监测5天,Sham组大鼠剥离双肾表面筋膜,也采取同AKI大鼠相同的处理。监测两组大鼠处于自然状态下连续5天的自发性心率变化及室性心律失常情况。造模6周后,测量两组大鼠的心室有效不应期(ERP)和室性心动过速(简称室速)诱发率。结果AKI组大鼠术后连续记录5天心电记录监测示:AKI组大鼠5天均出现室性早搏(简称室早),为1993(789,4220.5)个,5天均出现室速。Sham组大鼠无室速,5天出现单个室早20(5.75,150.5)个,P<0.05。造模6周后行心电生理实验,AKI组大鼠室速诱发率(71.67±14.03)%高于Sham组大鼠(15.00±7.98)%,P<0.05;AKI组大鼠心室ERP(47.79±3.86)ms低于Sham组大鼠(68.67±8.77)ms,P<0.05。结论5/6肾切除大鼠AKI期间心率减慢,且昼夜变化延迟,出现自发性室性心律失常,6周后ERP缩短、室速诱发率升高。

Objective To establish a rat model of chronic kidneydisease induced by 5/6 nephrectomy,and to investigate spontaneous heart rate changes and ventricular arrhythmia and ventricular electrophysiological characteristicsduring acute kidney injury(AKI).Methods Twenty-eight SPF adult male SD rats were randomly divided into Sham group and AKI group after adaptive feeding for 1 week,each group included fourteen rats.The right kidney and 2/3 of the left kidney were removed in AKI group,take nine rats worn long-range wearable dynamic ECG monitoring product and recorded for five days.Sham group rats were strippedof the surface fascia of both kidneys,also worn long-range wearable dynamic ECG monitoring product and recorded for five days.The spontaneous heart rate changes and ventricular arrhythmias of two groups of rats in ambulatory state for 5 consecutive days were monitored.Ventricular tachycardia(VT)induction and ventricular effective refractory period in two groups of rats was measured at the sixth week of modeling.Resulls The ECG records of AKI group was continuously monitored for5 days after operation.The results showed that:The AKI rats had 1993(789,4220.5)ventricular premature beats(VPB)in 5 days.AKI rats had VT for 5 days.Sham group showed no VT and presented 20(5.75,150.5)single VPB in 5 days,P0.05.At the sixth week of modeling,electrophysiological experiments were performed,The induction rate of VT in AKI group(71.67±14.03)%was higher than that in Sham group(15.00±7.98)%,P0.05.ERP in AKI group(47.79±3.86)ms was lower than that in Sham group(68.67±8.77)ms,P0.05.Conclusion Heart rate decrease and delay circadian changesand spontaneous ventricular arrhythmias occurre during AKI in 5/6 nephrectomy rats.ERP is shortened and the induction rate of VT is increased on the 6th week.