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目的探讨阿托伐他汀对心房颤动(房颤)电生理机制的影响。方法 30只新西兰大白兔随机分为对照组、房颤组和阿托伐他汀组,各10只。房颤组和阿托伐他汀组采用快速心房起搏(频率600次/min)制作急性房颤模型,对照组仅植入电极不起搏,阿托伐他汀组起搏前用阿托伐他汀2mg/(kg.d)灌胃7d。观察起搏0,4,8,12,16,20,24h时房颤诱发率、房颤持续时间、心房有效不应期和频率适应性的变化。结果起搏后8,12,16,20,24h房颤组和阿托伐他汀组房颤诱发率高于对照组(P<0.05),房颤组高于阿托伐他汀组(P<0.05);房颤组和阿托伐他汀组房颤持续时间较对照组延长(P<0.05),阿托伐他汀组房颤持续时间的延长较房颤组减少,但差异无统计学意义(P>0.05);与对照组比较,起搏4h后房颤组心房有效不应期缩短(P<0.05),心房有效不应期频率适应性降低(P<0.05),随起搏时间延长呈进行性加重;阿托伐他汀组起搏12h后心房有效不应期高于房颤组(P<0.05),起搏8h后心房有效不应期频率适应性的降低较房颤组减少(P<0.05)。结论阿托伐他汀可有效抑制快速心房起搏兔心房肌的电重构,表现为抑制心房有效不应期缩短和心房有效不应期频率适应性不良,可有效预防房颤发生,但并不影响房颤维持时间。
Objective To investigate the effect of atorvastatin on the electrophysiological mechanism of atrial fibrillation (AF). Methods Thirty New Zealand white rabbits were randomly divided into control group, atrial fibrillation group and atorvastatin group. In the atrial fibrillation group and atorvastatin group, acute atrial fibrillation was induced by rapid atrial pacing (frequency 600 beats / min), while control group was implanted with only electrodes without pacing. Atorvastatin group was treated with atorvastatin 2mg / (kg.d) gavage 7d. Atrial fibrillation induction rate, duration of atrial fibrillation, atrial effective refractory period and frequency adaptability were observed at 0, 4, 8, 12, 16, 20 and 24 h after pacing. Results The incidence of atrial fibrillation in AF group and atorvastatin group was higher than that in control group at 8, 12, 16, 20, 24 h after pacing (P <0.05), but not in atorvastatin group (P <0.05) ). The duration of atrial fibrillation in atrial fibrillation group and atorvastatin group was longer than that in control group (P <0.05). The duration of atrial fibrillation in atropvastatin group was longer than that in atrial fibrillation group, but the difference was not statistically significant (P > 0.05). Compared with the control group, the atrial effective refractory period was shortened (P <0.05) and the frequency of atrial effective refractory period was decreased (P <0.05) 4h after pacing, which was accompanied by the prolongation of pacing time (P <0.05). After 12 h of pacing, the decrease of adaptive frequency of atrial effective refractory period was less than that of atrial fibrillation group (P < 0.05). Conclusions Atorvastatin can effectively inhibit the electrical remodeling of atrial myocardium in patients with rapid atrial pacing. It can inhibit the shortening of effective atrial refractory period and poor adaptive frequency of atrial effective refractory period, which can effectively prevent atrial fibrillation but not Affect the duration of atrial fibrillation.