This study examined the sodium nitroprusside (SNP) toxicity to central nervous system (CNS) in treatment of patients with aortic dissection (AD). The medical records of 191 AD patients who were admitted to Tongji Hosp...This study examined the sodium nitroprusside (SNP) toxicity to central nervous system (CNS) in treatment of patients with aortic dissection (AD). The medical records of 191 AD patients who were admitted to Tongji Hospital, China, from Jan. 1998 to Feb. 2009 were retrospectively analyzed. There were 140 cases of hypertension (73.3%) and 13 cases of Marfan syndrome (6.8%) among the 191 AD patients. A total of 157 patients were given SNP treatment. The toxic reactions of CNS occurred in 18 subjects (11.5%). Most of the adverse reactions occurred on the fifth day following SNP injection. SNP infusion rate was significantly higher in patients who developed CNS toxicity. It was suggested that systemic hypertension is the most common predisposing factor for AD. The combination of SNP with a β-receptor blocker is a medical therapy commonly used in patients with AD. Cyanide and thio-cyanate toxicity from SNP treatment is always the consequence of prolonged drug infusion or relatively high dose administration.展开更多
目的:探讨去甲肾上腺素(NE)的急性作用对糖尿病大鼠室性心律失常的影响及其机制。方法:将健康雄性大鼠分为对照组(C组,n=10)、糖尿病组(D组,n=10)和NE组(N组,n=10),D组大鼠经腹腔注射链脲佐菌素诱导,成功制备糖尿病模型,N组是在完成D组...目的:探讨去甲肾上腺素(NE)的急性作用对糖尿病大鼠室性心律失常的影响及其机制。方法:将健康雄性大鼠分为对照组(C组,n=10)、糖尿病组(D组,n=10)和NE组(N组,n=10),D组大鼠经腹腔注射链脲佐菌素诱导,成功制备糖尿病模型,N组是在完成D组数据采集后加入NE作用。通过电生理记录技术,观察心电图记录的心率、PR、RR和QT间期以及QT间期离散度变化;在体心室肌单相动作电位的幅度(APA)、最大上升速率(Maxdv/dt)、复极化恢复到10%、50%、90%时间(APD_(10)、APD_(50)、APD_(90)),以及复极化时程三角测量值(Triangulation)变化,基础刺激周长(BCL)为200 ms时心室有效不应期(ERP200),以及短阵快速刺激诱发室性心律失常的BCL和诱发率。酶解法分离单个心室肌细胞,全细胞膜片钳技术观察每组心室肌细胞瞬时外向钾电流(Ito)及其电流-电压(I-V)曲线改变。结果:与D组比较,N组心率减慢,PR、RR和QT间期延长以及QT离散度增加均非常显著(均P<0.05);且N组APA降低,Maxdv/dt减慢,APD_(10)、APD_(50)、APD_(90)和Triangulation的延长亦非常明显(均P<0.05);另外,N组ERP200和诱发室性心律失常BCL均明显延长,诱发率显著增加(均P<0.05);最后,N组Ito的幅度减小,当钳制电位为+50 m V时,N组大鼠心室肌细胞Ito的电流密度由D组的(12.09±2.29)pA/pF明显减小到(7.94±1.93)pA/pF(P<0.01),其Ito的I-V曲线处于D组的下面。结论:NE的急性作用在糖尿病引起心室电重构和交感神经调节功能损伤的基础上,使得糖尿病心室的电重构加重,易感性加强而更利于诱发室性心律失常,其机制可能与NE急性作用引起糖尿病心室肌细胞Ito减小有关。展开更多
文摘This study examined the sodium nitroprusside (SNP) toxicity to central nervous system (CNS) in treatment of patients with aortic dissection (AD). The medical records of 191 AD patients who were admitted to Tongji Hospital, China, from Jan. 1998 to Feb. 2009 were retrospectively analyzed. There were 140 cases of hypertension (73.3%) and 13 cases of Marfan syndrome (6.8%) among the 191 AD patients. A total of 157 patients were given SNP treatment. The toxic reactions of CNS occurred in 18 subjects (11.5%). Most of the adverse reactions occurred on the fifth day following SNP injection. SNP infusion rate was significantly higher in patients who developed CNS toxicity. It was suggested that systemic hypertension is the most common predisposing factor for AD. The combination of SNP with a β-receptor blocker is a medical therapy commonly used in patients with AD. Cyanide and thio-cyanate toxicity from SNP treatment is always the consequence of prolonged drug infusion or relatively high dose administration.
文摘目的:探讨去甲肾上腺素(NE)的急性作用对糖尿病大鼠室性心律失常的影响及其机制。方法:将健康雄性大鼠分为对照组(C组,n=10)、糖尿病组(D组,n=10)和NE组(N组,n=10),D组大鼠经腹腔注射链脲佐菌素诱导,成功制备糖尿病模型,N组是在完成D组数据采集后加入NE作用。通过电生理记录技术,观察心电图记录的心率、PR、RR和QT间期以及QT间期离散度变化;在体心室肌单相动作电位的幅度(APA)、最大上升速率(Maxdv/dt)、复极化恢复到10%、50%、90%时间(APD_(10)、APD_(50)、APD_(90)),以及复极化时程三角测量值(Triangulation)变化,基础刺激周长(BCL)为200 ms时心室有效不应期(ERP200),以及短阵快速刺激诱发室性心律失常的BCL和诱发率。酶解法分离单个心室肌细胞,全细胞膜片钳技术观察每组心室肌细胞瞬时外向钾电流(Ito)及其电流-电压(I-V)曲线改变。结果:与D组比较,N组心率减慢,PR、RR和QT间期延长以及QT离散度增加均非常显著(均P<0.05);且N组APA降低,Maxdv/dt减慢,APD_(10)、APD_(50)、APD_(90)和Triangulation的延长亦非常明显(均P<0.05);另外,N组ERP200和诱发室性心律失常BCL均明显延长,诱发率显著增加(均P<0.05);最后,N组Ito的幅度减小,当钳制电位为+50 m V时,N组大鼠心室肌细胞Ito的电流密度由D组的(12.09±2.29)pA/pF明显减小到(7.94±1.93)pA/pF(P<0.01),其Ito的I-V曲线处于D组的下面。结论:NE的急性作用在糖尿病引起心室电重构和交感神经调节功能损伤的基础上,使得糖尿病心室的电重构加重,易感性加强而更利于诱发室性心律失常,其机制可能与NE急性作用引起糖尿病心室肌细胞Ito减小有关。
