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目的探讨左旋-四氢巴马汀(L-THP)抗室性心律失常(VA)的作用及机制。方法采用跨室壁单向动作电位记录技术研究L-THP对犬在体三层心肌动作电位时程(APD90)、有效不应期(ERP)和跨室壁复极离散度(TDR)的影响;通过心肌局部给予异丙肾上腺素(Iso)模拟突发交感神经张力增加,观察L-THP对程序电刺激(PES)所致的VA发生率和诱发VA所需的最低Iso浓度的影响。结果L-THP延长三层心肌的APD90和ERP但减少TDR[(18.78±3.19)msvs(10.78±2.11)ms,P<0.01];降低PES对VA的诱发率(21.61%vs6.17%,χ2=14.864 5,P<0.005);增加诱发VA所需要的最低Iso浓度(4.64×10-6mg/mlvs3.59×10-3mg/ml,P<0.001);抑制局部Iso诱发的早期后除极和触发活动所引起的VA。结论L-THP有显著的抗VA作用,是一种有望成为抗VA的中药。
Objective To investigate the effect and mechanism of L-THP on ventricular arrhythmia (VA). Methods The effects of L-THP on three-layer myocardial action potential duration (APD90), effective refractory period (ERP) and transmural dispersion of repolarization (TDR) in dogs were studied by using one-way transversal one-way action potential recording . The effects of L-THP on the incidence of VA induced by electrical stimulation of procedure (PES) and the minimum concentration of Iso required to induce VA were observed by simulating the increase of sympathetic tone induced by intracardiac administration of isoproterenol (Iso). Results L-THP prolonged APD90 and ERP in three-layer myocardium but decreased TDR (18.78 ± 3.19) ms vs (10.78 ± 2.11) ms, P <0.01; decreased the induction rate of VA by PES (21.61% vs 6.17%, χ2 = 14.864 5, P <0.005). The lowest Iso concentration needed to induce VA (4.64 × 10-6mg / ml vs 3.59 × 10-3mg / ml, P <0.001) VA triggered by the activity. Conclusion L-THP has a significant anti-VA effect and is a promising anti-VA medicine.