切断左侧T3-T4交感干对建立持续性心房颤动模型的影响

目的：T3-T4交感神经节是心脏交感干的重要组成部分，切断左侧T3-T4交感干可以减弱交感神经对心脏的支配。本文拟研究切断左侧T3-T4交感干对建立持续性心房颤动（房颤）的影响。 方法：成年健康雄性比格犬12只，体重20~26kg。随机等分为2组（对照组和实验组），每组各6只。对照组：只应用左心房快速起搏建立犬持续性房颤模型，不做其他处理；实验组：先用剪刀分别在左侧T3上端及T4下端切断T3-T4交感干，再应用左心房快速起搏建立犬持续性房颤模型。在T3-T4交感干切断后30min、持续性房颤模型构建成功后1个月，分别记录比较两组犬的心室率；并比较两组犬持续性房颤模型的构建时间。 结果：实验组犬构建成持续性房颤的起搏时间，较对照组犬明显延长（对照组：4.5±1.0周，实验组：7.7±1.4周，P=0.001，t=-4.503）。与对照组相比，分离、切断左侧T3-T4交感干后30min（对照组：87.2±2.0 bpm，实验组：82.3±2.4 bpm，P=0.004，t=3.738）和持续性房颤构建成功1个月时（对照组：138.5±2.9 bpm，实验组：127.7±3.9 bpm，P＜0.001，t=5.490），实验组犬的平均心室率均明显减慢。 结论：切断T3-T4交感干可以延长持续性房颤的构建时间，并明显减慢持续性房颤犬的快速心室率，表明切断左侧T3-T4交感干可以有效抑制房颤的触发和维持。

Effects of left T3-T4 sympathicotomy on the establishment of persistent atrial fibrillation model

Objective: T3-T4 sympathetic ganglions are an important part of cardiac sympathetic trunk, and left T3-T4 sympathicotomy could decrease cardiac sympathetic innervation. The aim of this study is to explore the effects of left T3-T4 sympathicotomy on the establishment of persistent atrial fibrillation (AF). Methods: 12 mature healthy male beagle dogs (20-26 kg) were studied. They were randomly halving to two groups (experimental group and control group, 6 dogs for each group). The control group was merely performed with rapid left atrial pacing to induce persistent AF. The experimental group was disposed with left T3-T4 sympathicotomy and rapid left atrial pacing simultaneously. Ventricular rate (VR) was monitored separately at 30 minutes after left T3-T4 sympathicotomy, and one month after persistent AF was documented. Results: Persistent AF inducing time of the experimental group (7.7±1.4 weeks) was longer than that of the control group (4.5±1.0 weeks) (P=0.001, t=-4.503). At 30 minutes after left T3-T4 sympathicotomy, average VR was 82.3±2.4 bpm in experimental group, which was significantly slower than that of control group (87.2±2.0 bpm) (P=0.004, t=3.738). After persistent AF was documented for 1 month, average VR of experimental group (127.7±3.9 bpm) was also significantly slower versus that of control group (138.5±2.9 bpm) (P<0.001, t=5.490). Conclusions: Left T3-T4 sympathicotomy could prolong the inducing time of persistent AF and reduce the fast VR during AF in ambulatory dogs with pacing induced persistent AF, which demonstrated that left T3-T4 sympathicotomy could effectively inhibit the occurrence and maintenance of AF.