一種改良兔心房纖顫模型建立方法的研究

江燕　白雪　趙立志　潘洪　楊思進

摘要：目的 ?尋找一種操作簡便、可重復性高的房顫建模方法，為研究心房纖顫的發生機制以及治療方案奠定基礎。方法 ?將新西蘭兔30只隨機分為正常對照組、常規模型組、改良組，每組各10只，正常對照組僅暴露心房和分離肺靜脈，J形雙極起搏電極置于左心房，僅置入電極而不起搏;常規模型組暴露心房分離肺靜脈后將起搏電極縫在左心房，高頻起搏左心房起搏12 h;改良組暴露心房，分離肺靜脈，然后在肺靜脈主干任意處使用自制雙電極電刺激，進行程序期前刺激12 h，比較三組存活情況、房顫誘發率、房顫發作的心室率及房顫持續時間，測量完畢后分離左心耳進行HE染色，觀察三組左心耳纖維化程度。結果 ?三組死亡率均為10.00%，差異無統計學意義（P>0.05）;正常對照組未誘發出心律失常，常規模型組房顫有誘發率為50.00%，改良組誘發率為80.00%，差異有統計學意義（P<0.05）;常規模型組房顫發作時平均心室率為（121.00±15.35）次/min，低于改良組的（154.00±18.49）次/min，差異有統計學意義（P<0.05）;常規模型組房顫持續時間為（425.40±49.51）s，低于改良組的（817.60±39.16）s，差異有統計學意義（P<0.05）;改良組每倍鏡下心肌纖維化及細胞空泡程度高于常規模型組及對照組。結論 ?兔心房纖顫時左心耳的纖維化程度較正常竇性心律時增加，房顫發生時心耳也出現結構重構，本次改良方法可成功建立心房纖顫模型，且成功率高、方法簡單、重復性好，值得推廣。

關鍵詞：心房纖顫;兔;動物模型;改良

中圖分類號：R541.75 ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ?文獻標識碼：A ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ?DOI：10.3969/j.issn.1006-1959.2020.18.016

文章編號：1006-1959（2020）18-0051-04

Study on an Improved Method for Establishing Rabbit Atrial Fibrillation Model

JIANG Yan，BAI Xue，ZHAO Li-zhi，PAN Hong，YANG Si-jin

（Department of Cardiology，the Affiliated Hospital of Traditional Chinese Medicine，Southwest Medical University，

Luzhou 646000，Sichuan，China）

Abstract：Objective ?To find a simple and reproducible atrial fibrillation modeling method to lay the foundation for the study of the mechanism of atrial fibrillation and treatment options. Methods ?30 New Zealand rabbits were randomly divided into normal control group， conventional model group， and modified group， each with 10 rabbits. The normal control group only exposed the atrium and separated the pulmonary vein. The J-shaped bipolar pacing electrode was placed in the left atrium and only placed the electrode is inserted without pacing; the conventional model group was exposed to the atrium and the pulmonary vein is separated， the pacing electrode was sewn to the left atrium， and the left atrium was paced with high frequency pacing for 12 h; the modified group was exposed to the atrium， separates the pulmonary vein， and then use it anywhere in the pulmonary vein self-made dual-electrode electrical stimulation， performed pre-procedural stimulation for 12 h， compared the survival， atrial fibrillation induction rate， ventricular rate of atrial fibrillation and the duration of atrial fibrillation in the three groups. After the measurement， the left atrial appendage was separated for HE staining， and the three groups were observed The degree of left atrial appendage fibrosis.Results ?The mortality rate of the three groups was 10.00%，the difference was not statistically significant （P>0.05）; the normal control group did not induce arrhythmia， the induction rate of atrial fibrillation in the conventional model group was 50.00%， and the induction rate of the modified group was 80.00%，the difference was statistically significant （P<0.05）; the average ventricular rate during the onset of atrial fibrillation in the conventional model group was （121.00±15.35） beats/min， which was lower than that of the modified group （154.00±18.49） beats/min，the difference was statistically significant （P<0.05）; The duration of atrial fibrillation in the conventional model group was （425.40±49.51） s， which was lower than （817.60±39.16） s in the modified group，the difference was statistically significant （P<0.05）; The degree of muscle fibrosis and cell vacuolation was higher than that of the conventional model group and the control group.Conclusion ?The degree of fibrosis of the left atrial appendage in rabbits with atrial fibrillation was higher than that of normal sinus rhythm， and the structure of the atrial appendage was also remodeled when atrial fibrillation occurs. This modified method could successfully establish atrial fibrillation model with high success rate and simple method，good repeatability， worthy of promotion.

Key words：Atrial fibrillation;Rabbit;Animal model;Improvement

心房纖顫是臨床上常見的心律失常之一，隨著人口老齡化，房顫的發生率呈上升趨勢，據不完全統計，大于80歲人群中，房顫發生率高達10%，高危心臟病患者人數可達30%[1]。房顫時心房的有效收縮消失，心排血量降低、血液瘀滯，容易形成附壁血栓，從而導致栓心力衰竭、栓塞等不良事件[2]，使患者生活質量降低、死亡率升高，給社會帶來巨大負擔，此一直是心血管領域研究的熱點和難點。很多疾病都可導致心房纖顫的發生，如心臟瓣膜病、缺血性心肌病、高血壓、甲亢、糖尿病、縮窄性心包炎、慢性肺源性心臟病等[3]，但也有少許患者為單純性孤立性房顫。近年……