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目的:观察口服门冬氨酸钾镁对肥厚心肌室性心律失常的影响并探讨门冬氨酸钾镁抗心律失常的作用机制。方法:将家兔随机分为假手术组、心肌肥厚组和门冬氨酸钾镁组。假手术组开腹但不行腹主动脉缩窄术,心肌肥厚组和门冬氨酸钾镁组采用腹主动脉缩窄术制备家兔心肌肥厚模型,喂养8周,制备兔左心室楔形心肌块,利用浮置玻璃微电极法同步记录楔形心肌块跨壁心电图和内、外膜心肌细胞跨膜动作电位,观察各组QT间期和内、外膜心肌细胞跨膜动作电位以及跨室壁复极离散度(TDR),程序电刺激诱发室性心律失常,记录早期后除极(EAD)和尖端扭转型室性心动过速(TDP)的诱发率。结果:门冬氨酸钾镁组和心肌肥厚组QT间期和内、外膜心肌细胞跨膜动作电位复极90%时程(APD90)和TDR较假手术组明显延长(均P<0.01)。门冬氨酸钾镁组与心肌肥厚组相比以上各项指标均明显缩短(均P<0.05)。假手术组、心肌肥厚组和门冬氨酸钾镁组EAD的发生率分别为0、100%和50%,TDP的发生率分别为0、40%和10%。心肌肥厚组与假手术组相比差异有统计学意义(P<0.01),门冬氨酸钾镁组与心肌肥厚组相比EAD和TDP的发生率明显降低(P<0.01)。结论:肥厚心肌TDR增大,心律失常的发生率显著升高。门冬氨酸钾镁降低TDR,可明显降低EAD和TDP的发生率。
Objective: To observe the effect of oral administration of potassium magnesium aspartate on hypertrophic ventricular arrhythmias and explore the mechanism of anti-arrhythmia of potassium and magnesium aspartate. Methods: Rabbits were randomly divided into sham operation group, cardiac hypertrophy group and potassium magnesium aspartate group. The rabbits in the sham-operated group were given laparotomy without abdominal aorta constriction. The model of myocardial hypertrophy was induced by abdominal aorta constriction in cardiac hypertrophy group and potassium-magnesium aspartate group. The rats were fed for 8 weeks to prepare the left ventricular wedge-shaped myocardial block , The floating electrocardiogram and the transmembrane action potentials of cardiomyocytes were simultaneously recorded by the floating glass microelectrode method. The transmembrane action potentials of transmembrane and the transmembrane potential (TDR), programmed electrical stimulation induced ventricular arrhythmia, and recorded rates of early post-anodal depolarization (EAD) and torsades de pointes (TDP). RESULTS: The APT90 and TDR of QT interval and the transmembrane action potentials of cardiomyocytes in aspartate potassium group and cardiac hypertrophy group were significantly longer than those in sham operation group (all P <0.01) . Compared with myocardial hypertrophy group, all the above indexes were significantly shortened (P <0.05). The incidences of EAD in sham operation group, cardiac hypertrophy group and potassium magnesium aspartate group were 0, 100% and 50% respectively, and the incidence of TDP was 0, 40% and 10% respectively. Compared with the sham operation group, the myocardial hypertrophy group had significant difference (P <0.01). The incidence of EAD and TDP in the potassium magnesium aspartate group was significantly lower than that in the cardiac hypertrophy group (P <0.01). Conclusion: The hypertrophic myocardium TDR increased, the incidence of arrhythmia was significantly increased. Potassium and magnesium aspartate reduce TDR, can significantly reduce the incidence of EAD and TDP.