【摘要】：目的:探討急性腎損傷早期對室性心律失常發(fā)生及心功能影響。方法:21只新西蘭大白兔隨機分配為假手術(shù)組(sham組,n=6),缺血再灌注組(I/R組,n=15),I/R組通過結(jié)扎雙側(cè)腎動靜脈1h,再灌注4h,建立急性腎損傷模型,sham組行不進行雙側(cè)腎動靜脈結(jié)扎的假手術(shù)。結(jié)果:(1)雙側(cè)腎動靜脈結(jié)扎1h再灌注4h可以成功建立腎臟缺血再灌注引起的急性腎損傷模型。(2)I/R組與sham組缺血1h及再灌注4h比較,心率減慢、dERP明顯增加(p0.05),缺血與再灌注前后的QT間期、QTc、ERP相比較無明顯差異(P0.05)。(3)I/R組與sham組再灌注4h心臟超聲比較,左室舒張末大小、收縮末大小、射血分數(shù)各時間點比較差異無統(tǒng)計學(xué)意義(P0.05)。(4)I/R組與sham組缺血前BNP、cTn-T濃度差異無統(tǒng)計學(xué)意義(p0.05),腎臟缺血1h及再灌注4h,I/R組BNP、cTn-T濃度明顯高于sham組(p0.001)。(5)sham組整個實驗過程中未出現(xiàn)室性性心律失常,I/R組在腎臟缺血1h時2只兔子出現(xiàn)偶發(fā)室性早搏,再灌注4h時5只兔子出現(xiàn)頻發(fā)室性早搏。兩組在整個實驗過程中未能誘發(fā)室性心動過速、心室顫動等惡性心律失常。(6)I/R組腎臟缺血1h及再灌注4h,TNF-、IL-6、CRP濃度與sham組比較均明顯升高(p0.05)。結(jié)論:急性腎損傷早期增加室性心律失常發(fā)生率,其機制可能與急性腎損傷所致的炎癥反應(yīng)引起心肌細胞凋亡,增加心肌復(fù)極不同步性增加,進一步影響心室不應(yīng)期離散度有關(guān)。但是早期急性腎損傷不會增加室速、室顫等惡性心律失常發(fā)生率。
[Abstract]:Objective: to investigate the effects of early acute renal injury on ventricular arrhythmia and cardiac function. Methods: Twenty-one New Zealand white rabbits were randomly assigned to sham operation group (sham group, n = 6), ischemia reperfusion group (I / R group, n = 15), and I / R group to establish acute renal injury model by ligating bilateral renal arteriovenous vessels for 1 h and reperfusion for 4 h. Sham group received sham operation without bilateral renal arteriovenous ligation. Results: (1) the acute renal injury induced by renal ischemia and reperfusion could be successfully established by bilateral renal arteriovenous ligation for 1 h and reperfusion for 4 h. (2) the heart rate of I / R group was slower than that of sham group for 1 h and 4 h after reperfusion. DERP increased significantly (p0.05). There was no significant difference in QT interval before and after ischemia and reperfusion between I / R group and sham group (P0.05). (3). The left ventricular end diastolic size and end systolic size were compared between I / R group and sham group for 4 h reperfusion. There was no significant difference in ejection fraction at different time points (P0.05). (4). There was no significant difference in BNP,cTn-T concentration between I / R group and sham group before ischemia (p0. 05), but there was no significant difference in BNP, concentration in renal ischemia 1 h and reperfusion 4 h in I / R group (p0. 05). The concentration of cTn-T was significantly higher than that in the sham group (p0.001). (5) sham group. There was no ventricular arrhythmia in the whole experiment. In the I / R group, two rabbits had occasional ventricular premature beats after 1 hour of renal ischemia. Ventricular premature beats occurred frequently in 5 rabbits after 4 h reperfusion. In both groups, ventricular tachycardia, ventricular fibrillation and other malignant arrhythmias could not be induced during the whole experiment. (6) the concentration of TNF-IL-6 CRP in the I / R group was significantly higher than that in the sham group at 1 h after ischemia and 4 h after reperfusion (p0.05). Conclusion: the incidence of ventricular arrhythmia is increased in the early stage of acute renal injury, and its mechanism may be related to the inflammatory reaction induced by acute renal injury, which may lead to myocardial cell apoptosis and increase myocardial repolarization. Further influence on the dispersion of ventricular refractory period. But early acute renal injury does not increase the incidence of malignant arrhythmias such as ventricular tachycardia and ventricular fibrillation.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R692.5;R541.7

【參考文獻】

相關(guān)期刊論文 前3條

1 孫長喜;許靜;杜新平;師軍華;;慢性腎臟病患者腎功能狀態(tài)與冠狀動脈病變的關(guān)系[J];山東醫(yī)藥;2014年33期

2 程中偉;朱孔博;方理剛;張抒揚;嚴曉偉;朱文玲;方全;;慢性腎臟疾病增加慢性心力衰竭患者死亡率[J];中國心血管雜志;2012年02期

3 朱虹,楊進;急性腎功能衰竭動物模型的研究現(xiàn)狀和評價[J];實驗動物科學(xué)與管理;2005年02期

，

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