【摘要】 目的研究异丙嗪对注射用双黄连致心律失常的影响。方法采用在体和离体动物心电图和细胞内微电极技术,分别记录豚鼠的心电图和左心室乳头肌动作电位。结果在体心电图显示静脉注射双黄连(1 380 mg.kg-1)显著延长豚鼠P-R及QRS间期(P<0.05);累加静脉注射异丙嗪(1.93 mg.kg-1)进一步延长P-R及QRS间期(P<0.01),并显著延长QTc间期(P<0.01)。离体心电图表明异丙嗪(10μmol.L-1)进一步加重双黄连(3 g.L-1)延长豚鼠P-R间期的作用(P<0.01),并显著延长QRS间期(P<0.05);异丙嗪(50μmol.L-1)还显著延长双黄连(3 g.L-1)作用下的QTc间期(P<0.05)。上述剂量或浓度的双黄连或双黄连加异丙嗪均能显著减慢心率(P<0.05)。双黄连(3 g.L-1)加异丙嗪(26μmol.L-1)能使豚鼠左心室乳头肌动作电位部分消失。结论异丙嗪能加重注射用双黄连诱发的豚鼠缓慢性心律失常,临床上应禁用异丙嗪抢救注射用双黄连导致严重不良反应的患者。更多还原

【Abstract】 AIM To investigate the effect of promethazine on aggravating arrhythmia induced by Chinese herbal intravenous injection of Shuanghuanglian(SHL).METHODS In vivo,in vitro ECG and intracellular action potential recording techniques were used to analyze the P-R and QRS intervals and action potential.RESULTS In vivo ECG recording: SHL(1 380 mg.kg-1,intravenously) significantly prolonged the guinea pig P-R and QRS intervals and promethazine(1.93 mg.kg-1,intravenously) further deteriorated the prolongation effects of SHL(P < 0.05).In vitro ECG recording: promethazine(10 μmol.L-1) further aggravated the isolated guinea pig heart P-R and QRS intervals prolonged by SHL(3 g.L-1)(P < 0.05).Promethazine(50 μmol.L-1) prolonged the QTc intervals in presence of SHL(3 g.L-1).SHL or promethazine plus SHL at the above mentioned doses or concentrations significantly reduced the in vivo and in vitro heart rates(P < 0.05).Combined effects of promethazine(26 μmol.L-1) and SHL(3 g.L-1) partially eliminated action potential firing from guinea pig left ventricular papillary muscles.CONCLUSION Promethazine aggravated bradycardia mediated by SHL in the guinea pig.Promethazine could not be used to treat the severe side effect induced by SHL in clinic.更多还原