乌头碱致心律失常机制的研究进展

摘要

乌头类中药是中医临床常用的一类温热性中药,包括川乌、草乌和附子等,其主要成分均含有乌头碱.乌头碱的有效剂量和中毒剂量相差甚微,在饮片炮制不当、煎煮时间不够、剂量过大或误服等情况下易发生中毒.中毒后常出现全身多个系统的症状,其中以心血管系统症状尤为突出,通常表现为多种致命性心律失常的重叠出现.乌头碱致心律失常机制较复杂,目前尚不十分明确.本文结合相关研究报道,对乌头碱致心律失常毒性机制,如兴奋迷走神经,影响心肌离子通道电流,影响缝隙蛋白磷酸化状态,干扰线粒体能量代谢,促进心肌细胞凋亡,进行综述.%Aconitum plants, including Aconitum carmichaeli Debx.(Chuanwu), Aconitum kusnezoffi Reichb(Caowu), Radix Aconiti lateralis praeparata (Fuzi), etc, have been regarded as a type of warming medicine and been widely used in clinics of Traditional Chinese Medicine (TCM).Aconitine is one of the main effective ingredients of these aconitum herbs.The therapeutic dose of aconitine is close to its toxic dose.Poisoning can be easily induced if aconitum is overdosed or misused, or the herbs are improperly processed and inadequately decocted.Aconitine poisoning can give rise to various symptoms of several systems, among which the cardiovascular toxic symptoms that generally manifested as multiple fatal arrhythmias are particularly conspicuous.Currently, the certain mechanism of aconitine induced arrhythmias remains unclear due to the complexity.Thus, we summarized the proarrhythmic toxic mechanisms of aconitine by collecting and integrating the correlational research reports.