造影剂对心脏介入治疗中血管迷走性晕厥的影响  

Effect of radiograph contrast media on vasovagal syncope in heart catheterization

作　　者：查滨[1] 周殷[1] 张莉[1] 

机构地区：[1]哈尔滨242医院,150066

出　　处：《航空航天医药》2005年第3期3-4,共2页Aerospace Medicine

摘　　要：目的观察造影剂对心导管术中发生血管迷走性晕厥的影响。方法200例接受心导管手术患者分为二组,一组为使用造影剂组(冠脉造影组),一组为不便用造影剂组(射频消融组)。每组患者均为100例,观察并记录每位患者在术中及术后24h内血管迷走性晕厥的发生情况,并随机抽取30例,于术前及术后即刻用荧光法测定每位患者血浆中儿茶酚胺含量并观察其变化。结果冠状动脉造影组中血管迷走性晕厥的发生率远大于不使用造影剂的射频消融术组(11%vs%,P<0.05),冠状动脉造影组血浆儿茶酚胺含量的增高较射频消融术组明显(0.2424±0.0843vs0.1771±0.1480,P<0.05;0.0761±0.0606vs0.0324±0.1375,P<0.05)。结论①造影剂的确对心导管手术中血管迷走性晕厥的发生有影响。②血浆中儿茶酚胺的浓度过度增高在造影剂所致的血管迷走性晕厥的发生机制中占重要作用。③心导管手术中的血管迷走性晕厥发作多以血压下降为主,伴有窦性心动过缓,属于血管抑制型晕厥。Objective：The purpose of this paper is to show the effect of radiographic contrast media （RCM） on vasovagal syncope（VVS）in the patients with heart catheterization. Methods： There were 200 patients who received the heart catheterization in this investigation. They were divided two groups according to using RCM or not in the heart cateterization.The happeness of VVS were recorded in the course of catheterization and in 24 hours atter the procedure.The change of plasma catecholamine concertration was measured in 30 patients selected randomly from each group with the high-speedion-exchange column choromatography.Results： The occurrence of WS in the group in which the patients were performed with coronary angiography was more than that in the group in which the pafiedts were only performed with radiofrenquency ablation（11%vs 1%, P 〈 0.05）. The change of plasma catecholamine concentration was higher in the patients used contrast media（0.2424±0.0843 vs 0.1771± 0.1480, P 〈 0.05; 0.0761± 0.0606 vs 0.0324 ± 0.1375, P〈 0.05）. Conclusion： There was effect of RCM on the occurrence of VVS. The significant increase of catecholamine concentraiton may play an important role in the pathogenesis of VVS. VVS was characterized by transparent hypotension and gently sinus bradycardia in heart catheterization.

关 键 词：造影剂 血管迷走性晕厥 儿茶酚胺 

分 类 号：R815[医药卫生—放射医学]