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长QT间期扭转型室性心动过速发病机制探讨
引用本文:杨向军,惠杰,汪康平,蒋文平.长QT间期扭转型室性心动过速发病机制探讨[J].中国循环杂志,1993(7).
作者姓名:杨向军  惠杰  汪康平  蒋文平
作者单位:苏州医学院附属第一医院心血管研究室 (杨向军,惠杰,汪康平),苏州医学院附属第一医院心血管研究室(蒋文平)
摘    要:狗静脉注射氯化铯(CsCl)所致的多形性室性心动过速(室速)基本符合长QT间期扭转型室速(TdP)的特点。右室心内膜单相动作电位(MAP)记录表明,CsCl可诱发早期后除极电位(EAD),TdP发作与EAD密切相关,硫酸镁(MgSO_4)可使EAD消失,TdP也获控制,提示TdP为EAD触发活性所致。Cs~ 为细胞膜K~ 通道阻滞剂,延长复极时间,增加内向Na~ /Ca~(2 )流,由此产生EAD,而Mg~(2 )为细胞膜K~ 通道激动剂,因此,Mg~(2 )对Cs~ 具对抗作用。

关 键 词:早期后除极电位  尖端扭转型室性心动过速  氯化铯  硫酸镁

STUDY OF THE MECHANISM OF TORSADE DE POINTS WITH LONG QT INTERVAL
Yang Xiang-Jun,Hui Jie,Wang Kang-Ping.STUDY OF THE MECHANISM OF TORSADE DE POINTS WITH LONG QT INTERVAL[J].Chinese Circulation Journal,1993(7).
Authors:Yang Xiang-Jun  Hui Jie  Wang Kang-Ping
Institution:Yang Xiang-Jun,Hui Jie,Wang Kang-Ping Department of Cardiology,The First Affiliated Hospital of Suzhou Medical College,Suzhou
Abstract:Torsade de points (TdP) with long QT is a common serious arrhythmia clinically, The mechanism of TdP is not clear. The features of polymorphous ventricular tachycardias induced by cesium chloride in dogs were conformed mainly to those of TdP. The recording of MAP from right ventrieular endocardium showed that EAD could be induced by cesium chloride, The occurrence of TdP was closely related to EAD. Magnesium sulfate eliminated EAD with simultaneous control of TdP showing that TdP with long QT was induced by triggered activity of EAD. Cesium chloride is a blocker of K~ channel which in turn prolongs repolarization, increases influx of Na~ /Ca~(2 ) and thus EAD is induced. Mg~(2 ) is an agonist of K~ channel, therefore it antagonizes the action of CS~ .
Keywords:Early afterdepolarization  Triggered activity  TdP  Cesium chloride  Magnesium sulfate
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