【摘要】：背景：近來越來越多的研究發(fā)現(xiàn)睡眠呼吸暫停(OSA)和房顫之間存在重要聯(lián)系,心房自主神經(jīng)節(jié)(GP)可能是其中的重要中間環(huán)節(jié)。 目的：驗證間斷低氧可導致心房自主神經(jīng)節(jié)(GP)過度激活并促進局灶性房顫發(fā)生的假設。 方法：多極電極導管縫于心房和所有的肺靜脈。調(diào)整呼吸機以發(fā)出間斷低氧刺激1小時制造急性間斷低氧模型,分別在各個位點測定基礎水平和間歇性低氧1h后該位點的房顫閾值(AF-TH)及心房有效不應期(ERP),1小時間斷低氧后在心房起搏(在不應期)之后延遲2ms給予40ms的高頻刺激(HFS;200Hz,0.01ms脈寬)以測定AF-TH。一個多極電極置于右前神經(jīng)節(jié)(ARGP)對該位點發(fā)出HFS(20Hz,0.1ms脈寬)以誘導竇率(SR)減慢。從ARGP記錄神經(jīng)活性。 結果：(1)1小時間歇性低氧誘導的AF-TH, ERP的在所有記錄部位均減少(均P0.05)。(2)1小時間歇性缺氧使得刺激ARGP誘導的SR減慢反應易化,提示間斷性缺氧增強ARGP功能。(3)1小時間歇性缺氧使得的從ARGP記錄神經(jīng)活動的頻率和幅度均顯著增加。 結論：1小時的間歇性低氧可增加AF誘發(fā)性和對副交感神經(jīng)刺激的變時性反應；這些作用的潛在機制可能是增高GP活性。
[Abstract]:Background: recently, more and more studies have found that there is an important relationship between sleep apnea (OSA) and atrial fibrillation. (GP) may be an important intermediate link in atrial autonomic ganglion. Aim: to test the hypothesis that intermittent hypoxia leads to excessive activation of (GP) in the autonomic ganglion and promotes the occurrence of focal atrial fibrillation. Methods: the multipole electrode catheter was sutured in the atrium and all pulmonary veins. The acute intermittent hypoxia model was established by adjusting the ventilator to emit intermittent hypoxic stimulation for 1 hour. The basal level and atrial fibrillation threshold (AF-TH) at each site and atrial effective refractory period (ERP),) were measured at each site after 1 hour of intermittent hypoxia. 1 hour intermittent hypoxia after atrial pacing (during refractory period) delays high frequency stimulation of 40ms by 2ms (HFS;) Determination of AF-TH. by 200Hz 0. 01 Ms pulse width A multipole electrode was placed in the right anterior ganglion (ARGP) to emit HFS (20 Hz ~ 0. 1 Ms pulse width) to induce sinus rate (SR) to slow down. Nerve activity was recorded from ARGP. Results: (1) 1 hour intermittent hypoxia induced AF-TH, ERP decreased in all recording sites (P0.05). (2) 1 hour intermittent hypoxia facilitated the SR response induced by ARGP. It suggested that intermittent hypoxia enhanced the function of ARGP. (3) the frequency and amplitude of nerve activity recorded from ARGP were significantly increased after 1 hour intermittent hypoxia. Conclusion: intermittent hypoxia for one hour can increase the AF induction and the chronotropic response to parasympathetic nerve stimulation, and the underlying mechanism of these effects may be the increase of GP activity.
【學位授予單位】：武漢大學
【學位級別】：博士
【學位授予年份】：2014
【分類號】：R541.75;R766

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