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目的 观察普罗帕酮对犬在体心脏缺血性快速室性心律失常的心电生理影响并与普鲁卡因胺对比 ,以探讨其抗缺血性快速室性心律失常的效果及作用机制。方法 用冠状动脉左前降支结扎并部分再灌注法造成犬急性前壁心肌梗死 ,5～ 8d后 ,辅以心室程控电刺激 (PES)技术及冠状动脉内恒定微量直流电刺激技术 ,并诱发与终止持续性室性心动过速和心室纤颤 ,制备成犬急性心肌缺血再灌注后可控性快速室性心律失常的在体心脏心电模型 ,心电图对比观察普罗帕酮及普鲁卡因胺的抗心律失常作用。结果 普罗帕酮及普鲁卡因胺均能显著地延长心肌梗死犬的心电图QTc间期 (P <0 .0 1 )及正常和缺血心肌的有效不应期 (P <0 .0 1 ) ,降低缺血心肌和左室心肌的有效不应期离散度 (P <0 .0 1 ) ,提高正常心肌和缺血心肌的舒张期兴奋阈值 (P <0 .0 1 ) ,抑制PES诱发的持续性室性心动过速和心室纤颤 (P <0 .0 1 ) ,并能预防犬急性心肌梗死后再次缺血所致的自发性室性心动过速和心室纤颤 (P <0 .0 5)。结论 ①该犬在体心脏心电药理学实验模型具有较好的重复性、可靠性及临床相关性 ,是一种有价值的心电药理学实验研究模型。②普罗帕酮及普鲁卡因胺均具有抗缺血性快速室性心律失常的心电生理作用 ,是有效的抗颤药物 ,两药效果相似
Objective To observe the electrophysiological effects of propafenone on canine ischemic ventricular tachyarrhythmia in dogs and compare with procainamide to explore its anti-ischemic ventricular tachyarrhythmia effect and its mechanism. Methods Acute anterior myocardial infarction was induced in dogs by ligation of the left anterior descending coronary artery and partial reperfusion. After 5 ~ 8 days, ventricular programmed electrical stimulation (PES) and constant micro-DC stimulation of coronary artery were induced and terminated Continuous ventricular tachycardia and ventricular fibrillation, the preparation of canine acute myocardial ischemia-reperfusion control of ventricular tachyarrhythmias in vivo heart electrocardiogram model, ECG comparison propafenone and procainamide Anti-arrhythmic effect. Results Both propafenone and procainamide could significantly prolong the QTc interval (P <0.01) and the effective refractory period (P <0.01) in normal and ischemic myocardium in dogs with myocardial infarction , Reduce the effective refractory period dispersion of ischemic myocardium and left ventricular myocardium (P <0.01), increase the diastolic threshold of normal and ischemic myocardium (P <0.01), and inhibit PES-induced Persistent ventricular tachycardia and ventricular fibrillation (P <0. 01), and can prevent spontaneous ventricular tachycardia and ventricular fibrillation caused by ischemic reperfusion after acute myocardial infarction (P <0. 0 5). Conclusion ① The dog model of electrocardiogram pharmacokinetics in vivo has good reproducibility, reliability and clinical relevance. It is a valuable experimental model for ECG pharmacology research. ② propafenone and procainamide have anti-ischemic ventricular tachyarrhythmia of the electrophysiological effects, is an effective anti-tremor drugs, two drugs have similar effects