《中国康复理论与实践》

《中国康复理论与实践》 ›› 2008, Vol. 14 ›› Issue (04): 316-318.

• 专题 • 上一篇    下一篇

兔心肌缺血与再灌注过程对心电图QRS合值及心肌酶的影响

高颖; 彭伊; 张建龙; 马琪   

  1. 新疆医科大学第一附属医院心脏中心,新疆乌鲁木齐市 830000
  • 收稿日期:2007-11-13 出版日期:2008-04-01 发布日期:2008-04-01

Effect of Ischemia-reperfusion on Combined Data of QRS Complex Waves of Electrocardiogram and Myocardial Enzymes in Rabbits

GAO Ying, PENG Yi, ZHANG Jian-long, et al.   

  1. The Department of Cardiovascular, First Affiliated Hospital of Xinjiang Medicial University, Urumchi 830000, Xinjiang, China
  • Received:2007-11-13 Published:2008-04-01 Online:2008-04-01

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摘要： 目的探讨心肌缺血与再灌注过程心电图QRS合值及心肌酶的变化,观察Ⅱ导联ST段、T波变化及心律失常发生情况。方法采用分别结扎兔冠状动脉左回旋支10、20、30、40min并再灌60min制备4组(A、B、C、D组)缺血/再灌注动物模型,另设假手术组,分别于再灌注60min时观察QRS合值、Ⅱ导联ST段、T波及心律失常发生情况,测定丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、乳酸脱氢酶(LDH)、肌酸激酶(CK)及肌酸激酶同工酶(CK-MB)。结果D组QRS合值较假手术组、A组及B组明增高(P<0.05);各组间T波差异无统计学意义(P>0.05);术前结扎组19只兔及假手术组5只出现Ⅲ导联ST段J点抬高(<0.1mV)属正常范围,术后结扎组21只兔Ⅱ导联出现ST段单向曲线型抬高,2只兔出现水平型ST段压低,1只兔ST段无改变;再灌注60min,21只兔中2只ST段单向曲线再抬高>0.1mV,2只恢复正常,1只反而压低,其余均出现ST段回降>0.2mV;D组2只兔分别于再灌注40min及43min因窦性心动过缓死亡,2只兔于再灌注3～5min出现室性早搏;D组AST及LDH增高(P<0.05),缺血/再灌注组CK均高于假手术组(P<0.05),C组与D组CK-MB较假手术组增高(P<0.05)。结论缺血/再灌注模型动物LDH、CK-MB及QRS合值水平增高与缺血再灌注损伤有关。

关键词: 缺血/再灌注, 心电图QRS合值, 心肌酶

Abstract: Objective To explore the changes of QRS combined data and myocardial enzymes during ischemia-reperfusion in rabbits,and observe the changes of ST segment and T wave of lead Ⅱ,and arrhythmias.Methods The models of ischemia-reperfusion(A,B,C and D group)were made by ligating the left circumflex territory for 10,20,30,40 min and then reperfusion for 60 min.The sham-operated control was designed.The changes of the QRS combined data,ST segment and T wave and rises of arrhythmias about electrocardiogram of lead Ⅱ were observed.Meanwhile,the activity of serum myocardial enzymes was measured.Results The QRS combined data of the group D was higher significantly than the sham-operated control,group A and group B(P<0.05).T waves of different groups were not significantly different(P>0.05).The J spot elevation of lead Ⅲ in 19 rabbits of the ligating group and 5 rabbits of the sham-operated control was observed before operation.The changes of ST segment were clearly observed in the ligating group after operation:apparent mono-phasic curve elevation in 21 rabbits,level type depression in 2 and no change in 1.ST segment of other animals was declined more than 0.2 mV in 60 min reperfusion,except ST segment of 2 rabbits elevated again more than 0.1 mV,2 rabbits were normal and 1 rabbit was depressed.Two rabbits of the group D respectively died of sinus bradycardia in reperfusion 40 min and 43 min,and two rabbits appeared premature ventricalar contraction during reperfusion 3-5 min.The activity of serum aspartate aminotransferase(AST)and lactate dehydrogenase(LDH)obviously increased in the group D(P<0.05).Creatine kinase(CK)was high significantly except the sham-operated control(P<0.05).The activity of serum CK-MB of the groups C and group D was significantly higher than that of the sham-operated control(P<0.05).Conclusion The rising of LDH,CK-MB and QRS combined date in the group D is related with ischemia-reperfusion injury.

Key words: ischemia-reperfusion, combined data of QRS complex waves of electrocardiogram, myocardial enzyme