阿托伐他汀对心房颤动预防作用及其电生理机制的实验研究

目的探讨阿托伐他汀对心房颤动（房颤）电生理机制的影响。方法 30只新西兰大白兔随机分为对照组、房颤组和阿托伐他汀组,各10只。房颤组和阿托伐他汀组采用快速心房起搏（频率600次/min）制作急性房颤模型,对照组仅植入电极不起搏,阿托伐他汀组起搏前用阿托伐他汀2mg/（kg.d）灌胃7d。观察起搏0,4,8,12,16,20,24h时房颤诱发率、房颤持续时间、心房有效不应期和频率适应性的变化。结果起搏后8,12,16,20,24h房颤组和阿托伐他汀组房颤诱发率高于对照组（P〈0.05）,房颤组高于阿托伐他汀组（P〈0.05）;房颤组和阿托伐他汀组房颤持续时间较对照组延长（P〈0.05）,阿托伐他汀组房颤持续时间的延长较房颤组减少,但差异无统计学意义（P〉0.05）;与对照组比较,起搏4h后房颤组心房有效不应期缩短（P〈0.05）,心房有效不应期频率适应性降低（P〈0.05）,随起搏时间延长呈进行性加重;阿托伐他汀组起搏12h后心房有效不应期高于房颤组（P〈0.05）,起搏8h后心房有效不应期频率适应性的降低较房颤组减少（P〈0.05）。结论阿托伐他汀可有效抑制快速心房起搏兔心房肌的电重构,表现为抑制心房有效不应期缩短和心房有效不应期频率适应性不良,可有效预防房颤发生,但并不影响房颤维持时间。

Preventive role of atorvastatin in atrial fibrillation and its electrophysiological mechanism

Objective To explore the effects of atorvastatin on atrial fibrillation（AF） and electrophysiological mechanism.Methods Thirty New Zealand rabbits were randomly divided into control group,AF group and atorvastatin group,with 10 cases in each group.Control group was not paced,AF group underwent rapid atrial pacing with frequency of 600 beats per minute,and atorvastatin group underwent rapid atrial pacing following lavage for 7 days with 2 mg/（kg·d） atorvastatin.The changes of AF inducibility,effective refractory period（ERP） and adaptation of atrial effective refractory period（AERP） were observed 0,4,8,12,16,20,and 24 hours after pacing.Results The AF inducibility was significantly higher in AF group and atorvastatin group than that in control group after pacing for 8 to 24 hours（P0.05）,and was higher in AF group than that in atorvastatin group（P0.05）.The duration of AF was significantly prolonged in AF group and atorvastatin group compared with control group（P0.05）.There was no difference in the prolongation of AF duration between atorvastatin group and AF group（P0.05）.The AERP was markedly shortened（P0.05） and the adaptation of AERP was markedly decreased and showed aggravating trend as the prolong of pacing time in AF group compared with control group（P0.05）.AERP was obviously higher in atorvastatin group than that in AF group after pacing for 12 hours（P0.05）.The adaptation of AERP was markedly decreased in atorvastatin group compared with AF group after pacing for 8 hours（P0.05）.Conclusion Atorvastatin can inhibit the atrial electrophysiologic remodeling in AF rabbits induced by rapid atrial pacing,including inhibiting the shortening of AERP and decreasing the adaptation of AERP.Atorvastatin has no effect on duration of AF.