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目的 通过普伐他汀干预快速起搏的心房肌 ,观察普伐他汀对快速起搏心房肌结构重构的作用 ,从而探讨他汀药治疗心房颤动 (房颤 )的机制及可行性。方法 将 17条犬分为对照组、起搏组及干预组。对照组不给任何处理及干预 ;起搏组采用快速起搏心房的方法建立房颤模型 ,分别给犬植入 4 2 0～ 5 0 0次 /min的固定频率起搏器 ,起搏时间为 4周。干预组以同样的方法植入起搏器并同时服用普伐他汀 4周。采用超声心动图检查起搏组及干预组起搏前及起搏、干预 4周后左心房前后径及各项容量指标。分别取 3组犬左心耳心房肌进行苏木精 伊红及Masson染色 ,观察细胞形态 ,有无炎细胞浸润及纤维化情况。结果 (1)心脏超声部分 :起搏组术后 4周与术前比左心房前后径及各项容量指标均有显著增加 ,干预组术后 4周与术前比差异无显著性 ;(2 )组织细胞学检查部分 :对照组 ,肌纤维排列整齐 ,胞浆染色均匀 ,间质无炎细胞浸润。起搏组胞膜不清 ,胞浆淡染 ,部分细胞可见空泡变性及片状粘液变性。间质可见炎细胞浸润 ,可见间质及心肌细胞纤维化。干预组 ,部分细胞胞膜不清 ,胞浆淡染 ,无炎细胞浸润 ,无间质及心肌细胞纤维化。结论 普伐他汀可显著抑制快速起搏引起的心房结构重构。
Objective To investigate the mechanism and feasibility of pravastatin in the treatment of atrial fibrillation (AF) by pravastatin treatment of rapid paced atrial myocardium and observation of the effect of pravastatin on the structure reconstruction of atrial pacing rapid atrial pacing. Methods 17 dogs were divided into control group, pacing group and intervention group. The control group did not give any treatment and intervention; pacemaker group using atrial fibrillation rapid atrial fibrillation model were established, the dogs were implanted 4200 ~ 500 times / min fixed frequency pacemaker, pacing time was 4 weeks. The intervention group was implanted with a pacemaker in the same way and with pravastatin for 4 weeks. Echocardiography was used to check the anteroposterior diameter of the left atrium before and after pacing and intervention in the pacing group and intervention group. Left atrial appendage atrial myocardium were taken from three groups, respectively. Hematoxylin eosin and Masson staining were performed to observe the cell morphology, inflammatory cell infiltration and fibrosis. Results (1) Echocardiography: The amplitude of anteroposterior diameter of the left atrium and volume index of the pacing group were significantly increased 4 weeks after operation and no significant difference was found between the 4 weeks and the preoperative ) Histological examination part: control group, muscle fibers arranged neatly, cytoplasm stained evenly, interstitial inflammatory cell infiltration. Pacing cell group is not clear, light cytoplasm staining, some cells visible vacuolar degeneration and mucilage degeneration. Interstitial inflammatory cell infiltration can be seen interstitial and cardiomyocyte fibrosis. Intervention group, part of the cell membrane unclear, light cytoplasm, non-inflammatory cell infiltration, interstitial and cardiomyocyte fibrosis. Conclusions Pravastatin can significantly inhibit atrial structural remodeling induced by rapid pacing.