萘普生对心肌电生理与收缩功能的影响

发布时间：2018-04-30 07:37

本文选题：萘普生 + 心电图　；参考：《上海交通大学学报(医学版)》2015年05期

【摘要】：目的观察非甾体消炎药萘普生对心脏电生理特征性的影响,探讨其对心脏的潜在不良反应及机制。方法采用Langendorff离体心脏灌流方法和细胞内微电极技术,观察萘普生对心肌细胞快、慢反应动作电位和离体心脏心肌收缩力、离体及整体心脏心电图的影响。结果萘普生呈浓度依赖地使豚鼠心室乳头肌快反应动作电位的时程(APD50和APD90)和有效不应期缩短,0期上升速率(Vmax)减慢;可使家兔窦房结慢反应动作电位4期自动除极速率(SDVP4)、窦房结自律性兴奋频率和动作电位0期上升幅值减小。在离体心脏心电图实验中,萘普生减慢窦性心率,明显延长RR间期和QRS波群的时程,当浓度在1×10-5mol/L时能引起严重的房室传导阻滞;同时,使心肌收缩力显著下降,且呈剂量依赖性变化。心率变异性(HRV)分析显示,萘普生显著增强低频段(0.04~0.15 Hz)功率(LF)、高频段(0.15~0.4 Hz)功率(HF),但其LF/HF比值显著减小,且呈浓度依赖性。结论萘普生可能通过抑制Na+、Ca2+离子通道,促进K+离子通道或通过对自主神经系统的调节,尤其是对副交感神经的调节而影响心功能。
[Abstract]:Objective to observe the effects of nonsteroidal anti-inflammatory drug naproxen on the electrophysiological characteristics of the heart and to explore its potential adverse effects on the heart and its mechanism. Methods the effects of naproxen on cardiomyocyte action potential, cardiac contractility and ECG in vitro and in vitro were observed by Langendorff perfusion method and intracellular microelectrode technique. Results naproxen in a concentration-dependent manner slowed down the duration of fast response action potential (APD50 and APD90) and the shortening of the effective refractory period (Vmax) in guinea pig papillary muscle. It can reduce the rate of SDVP4, the frequency of spontaneous excitation and the increasing amplitude of action potential in phase 0 of sinoatrial node in rabbits. In isolated cardiac electrocardiogram, naproxen slowed down sinus heart rate, prolonged the duration of RR interval and QRS wave group, and caused severe atrioventricular block when the concentration was 1 脳 10-5mol/L, at the same time, the contractility of myocardium decreased significantly. The changes were dose-dependent. Heart rate variability (HRV) analysis showed that naproxen significantly enhanced the power of 0.04 ~ 0.15 Hz in low frequency range and 0.150.40 Hz in high frequency band, but its LF/HF ratio decreased significantly in a concentration-dependent manner. Conclusion naproxen may affect cardiac function by inhibiting Na ~ (2 +) Ca ~ (2 +) channel promoting K ~ + channel or regulating autonomic nervous system especially parasympathetic nerve.
【作者单位】：上海交通大学基础医学院实验中心;上海医药高等专科学校解剖生理教研室;上海交通大学基础医学院药理学教研室;
【基金】：国家自然科学基金(81070010)~~
【分类号】：R96

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