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目的 观察不同剂量异丙酚、利多卡因预处理对在体大鼠心肌再灌注心律失常的影响。方法 SD大鼠 5 6只 ,随机分为 7组。Sham组 :假手术组 ;NS组 :生理盐水组 ;L5组 :利多卡因 5mg·kg-1组 ;L10 组 :利多卡因 10mg·kg-1组 ;P30 0 组 :异丙酚 0 3mg·kg-1·min-1组 ;P10 0 0 组 :异丙酚 1mg·kg-1·min-1组 ;L5+P30 0 组 :利多卡因 5mg·kg-1+异丙酚0 3mg·kg-1·min-1组。生理盐水或利多卡因于缺血前 5min静脉注射 ( 30s内注射完 ) ,异丙酚于缺血前 5min静脉持续输注至缺血开始为止。结扎冠脉左前降支使相应心肌缺血 15min ,然后放松结扎线再灌注 10min(Sham组不结扎冠脉 )。实验中持续监测血流动力学变化 ,ECG肢体Ⅱ导联记录再灌期间室性心律失常的发生。结果 异丙酚大剂量降低MAP且减慢HR(P <0 0 5 ) ,利多卡因两剂量和两药小剂量联合应用可减慢心率 (P <0 0 5 ,P <0 0 1)。异丙酚或利多卡因可减少再灌注期间室早的发生 (P <0 0 1) ,降低室颤发生率 (P <0 0 5 ) ,并缩短室速的持续时间 (P <0 0 1)。大剂量异丙酚或利多卡因或两药小剂量联合用药还可降低室速的发生率 (P <0 0 1)。结论 异丙酚、利多卡因预处理可有效地减轻再灌注心律失常的发生 ,两药小剂量合用比两药大剂量单用对血流动力?
Objective To observe the effects of propofol and lidocaine preconditioning on myocardial reperfusion arrhythmia in vivo. Methods Fifty-six SD rats were randomly divided into seven groups. Sham group: sham operation group; NS group: saline group; L5 group: lidocaine 5 mg · kg -1 group; L10 group: lidocaine 10 mg · kg -1 group; P30 0 group: propofol kg-1 · min-1 group; P10 0 0 group: propofol 1 mg · kg-1 · min-1 group; L5 + P30 0 group: lidocaine 5 mg · kg- -1 · min-1 group. Saline or lidocaine 5min before ischemia by intravenous injection (30s within the injection), propofol 5min before ischemia in the vein continuous infusion until the onset of ischemia. Ligation of the left anterior descending coronary artery so that the corresponding myocardial ischemia 15min, and then relax the ligature reperfusion 10min (Sham group without coronary artery ligation). The hemodynamic changes were continuously monitored in the experiment. The occurrence of ventricular arrhythmias during ECG reperfusion was recorded by ECG limb II lead. Results Propofol decreased MAP and slowed down HR (P <0 05) at high dose. The combination of two doses of lidocaine and low dose of two drugs reduced heart rate (P <0.05, P <0.01). Propofol or lidocaine decreased premature ventricular remodeling (P <0.01), reduced the incidence of ventricular fibrillation (P <0.05) and shortened the duration of ventricular tachycardia (P <0.01 ). High-dose propofol or lidocaine or low-dose combination therapy can reduce the incidence of ventricular tachycardia (P <0.01). Conclusion Propofol, lidocaine pretreatment can effectively reduce the incidence of reperfusion arrhythmia, two low-dose combination of two drugs than two high-dose single dose on hemodynamics?