星状神经节阻滞对家兔心肌梗死后心室肌电生理特性的影响

目的探讨星状神经节阻滞对家兔心肌梗死后心室肌电生理特性的影响。方法结扎新西兰大耳白兔冠状动脉前降支制备心肌梗死模型作为心肌梗死组（32只），假手术组32只作为对照组，两组均随机分为定、右侧星状神经节阻滞组及相应的对照组（各8只）。8周后先根据分组给予动物0．25％布比卡因0．5ml行左或右侧星状神经节阻滞（对照组以生理盐水代替），然后动物麻醉开胸暴露心脏，分别测量梗死周边区和假手术对应区域心室内、中、外膜层心肌组织单相动作电位复极90％的时限（MAPD90）、心室复极离散度（TDR）、有效不应期（ERP）和心室颤动（室颤）阈值。结果左侧星状神经节阻滞使梗死周边区3层心肌的MAPD90、ERP延长，TDR减小；室颤阈值增加（P〈0．05）。而右侧星状神经节阻滞则作用相反，缩短3层心肌的MAPD90、ERP，增大TDR，降低室颤阈值（P〈0．05），假手术组中左、右侧星状神经节阻滞的效应与前述结果一致。结论左侧星状神经节阻滞具有稳定心电活动的效应，可作为预防室性心律失常的一种手段，而右侧星状神经节阻滞不宜用于室性心律失常高危患者。

Effects of stellate ganglion block on myocardial electrophysiology in the infarct border zone in rabbits

Objective To investigate the effects of stellate ganglion block (SGB) on myocardial electro physiology in the infarct border zone. Methods Sixty-four New Zealand white rabbits were randomly assigned into two groups: MI group (n=32), ligation of the anterior descending coronary; SO, sham operation group (n=32), without coronary ligation. Both of MI group and SO group were divided into four subgroups according to the left or right SGB and the corresponding control (re = 8, each). For SGB, 0. 5 ml of 0. 25 % bupi vacaine was used. After eight weeks of surgery,90% of monophasic action potential duration (MAPD_(90)),effective re fractory period (ERP),transmural dispersion of repolarization (TDR).ventricular fibrillation threshold (VFT) were measured at the infarct border zone (MI group) and corresponding zone (SO group) following SGB. Result Compared with the corresponding control group,left SGB (LSGB) prolonged the MAPD_(90), reduced the TDR,and increased the ERP and VFT in both the MI group and SO group (P <0. 05). However,Right SGB (RSGB) shortened the MAPD^,increased the TDR,and reduced ERP and VFT in both the MI group and SO group (P<0.05). Conclusion LSGB can increase the electrophysiological stability of ventricular myocardium.