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目的:观察重组人肿瘤坏死因子受体融合蛋白(rhTNFR:Fc)对体外大鼠心脏急性缺血梗死后快速室性心律失常发生的影响,进一步探讨心肌急性缺血后心律失常机制及TNF-α在其中的作用。方法:将45只雄性大鼠随机分为3组,分别为对照组、急性心肌梗死组、急性心肌梗死加rhTNF:Fc组。Langenoff灌流大鼠体外心脏,结扎后2组大鼠的左前降支冠状动脉,记录心脏表面心电图,急性缺血0.5h后给予S1S2程序电刺激诱发室性心动过速或心室颤动,比较各个组间发生率的差异。结果:急性心肌梗死组出现室性心律失常的发生率明显高于对照组,差异有统计学意义(P<0.01)。急性心肌梗死加rhTNF:Fc组与急性心肌梗死组相比,心室颤动或室性心动过速发生率显著降低(P<0.01)。对照组与急性心肌梗死加rhTNF:Fc组差异无统计学意义。结论:特异性肿瘤坏死因子拮抗剂rhTNF:Fc能降低体外大鼠心脏急性心肌梗死后恶性心律失常的发生率。
OBJECTIVE: To observe the effect of rhTNFR (Fc) on the occurrence of rapid ventricular arrhythmia after acute ischemic infarction in rats and to further explore the mechanism of arrhythmia after myocardial ischemia and the effect of TNF-α In which role. Methods: 45 male rats were randomly divided into 3 groups: control group, acute myocardial infarction group, acute myocardial infarction group and rhTNF: Fc group. Rats were perfused with Langenoff heart in vitro. The left anterior descending coronary artery was ligated in the left anterior descending coronary artery. The electrocardiogram of the heart was recorded. After the acute ischemia 0.5h, the S1S2 program was given electrical stimulation to induce ventricular tachycardia or ventricular fibrillation. The difference in incidence. Results: The incidence of ventricular arrhythmia in acute myocardial infarction group was significantly higher than that in control group (P <0.01). The incidence of ventricular fibrillation or ventricular tachycardia in acute myocardial infarction plus rhTNF: Fc group was significantly lower than that in acute myocardial infarction group (P <0.01). There was no significant difference between control group and acute myocardial infarction plus rhTNF: Fc group. Conclusion: The specific tumor necrosis factor antagonist rhTNF: Fc can reduce the incidence of malignant arrhythmia after acute myocardial infarction in rats.