甲基强的松龙冲击疗法中动态心电图和心肌酶谱研究  

Changes of Dynamic Electrocardiogram and Myocardial Zymogram in Methylprednisolone Pulse Therapy

作　　者：张永葆[1] 徐劲[1] 齐治平[2] 马慧[1] 葛伟[1] 张鹏飞[1] 

机构地区：[1]安徽省巢湖市第一人民医院神经内科,238000 [2]安徽省巢湖市第一人民医院心电图室,238000

出　　处：《中华全科医学》2011年第1期51-52,共2页Chinese Journal of General Practice

摘　　要：目的观察甲基强的松龙冲击疗法(methylprednisolone pulse therapy,MPPT)治疗前和治疗中动态心电图和心肌酶谱的变化。方法 36例MPPT治疗的患者在治疗前和治疗中分别查动态心电图和心肌酶谱,比较治疗前和治疗中动态心电图中心律失常情况、心率变异性变化及心肌酶谱改变。结果 MPPT治疗中动态心电图检查显示心律失常较治疗前增多,主要有房早、短阵房速、室早、ST段改变等,1例出现短阵室速,心率变异性(HRV)分析24hSDNN、SDANNr、MSSD、PNN50均较治疗前降低,但差异无统计学意义(P>0.05);心肌酶谱检查治疗前与治疗中比较差异无统计学意义(P>0.05)。结论在控制好滴速和补钾下MPPT对心脏影响小,临床应用安全,但仍需做心电监护或每天2次常规心电图检查。Objective To observe the changes of dynamic electrocardiogram（DCG） and myocardial zymogram before and during the methylprednisolone pulse therapy（MPPT）. Methods Thirty six patients received DCG and myocardial zymogram tests before and during MPPT, the changes of arrhythmia condition, heart rate variability on DCG and myocardial zymogram before and during MPPT were compared. Results As compared with the results of DCG before MPPT,the events of arrhythmia,such as atrial premature beats, paroxysmal atrial taehycardia, ventricular premature beats, ST segment changes increased, and nonsustained ventricular tachycardia was found in one case,while SDNN, SDANN,rMSSD, PNNS0 of 24-hour HRV analysis were decreased on DCG during MPPT, but there was no significant difference （ P 〉 0.05 ） ; No significant difference in myocardial zymogram was found（ P 〉 0.05 ）. Conclusion MPPT has little side effect on the heart under well-done dropping speed control and potassium supplement, and ECG or routine ECG twice a day are necessary for its clinical application and safety.

关 键 词：甲基强的松龙冲击疗法 动态心电图 心肌酶谱 

分 类 号：R977.1[医药卫生—药品] R540.41[医药卫生—药学]