单次大剂量口服普罗帕酮及氟卡胺对心率变异性的影响  

Effect of a single large oral dose of prepafenone and flecainide on heart rate variability in pateints with ventricular premature contractions

作　　者：伍卫[1] 张旭明[1] 

机构地区：[1]广州中山医科大学孙逸仙纪念医院心内科,510120

出　　处：《岭南心血管病杂志》1998年第1期20-23,共4页South China Journal of Cardiovascular Diseases

基　　金：广东省科委青年科研基金

摘　　要：目的观察Ic类抗心律失常药物对心率变异性（HR）的影响。方法21例室性早搏（VPC）病人，平均年龄38．2±16．2岁。采用单盲交叉法，按随机先后给予单次大剂量口服普罗帕酮（400mg）、氟卡胺（200mg）以及安慰剂。服药前后记录动态心电图，分析HRV及VPC的变化。结果一次大剂量口服普罗帕酮或氟卡胺1小时以后，SD、rMSSD、rMSSD、pNN50均明显降低，并持续至用药后至少6小时。氟卡胺可同时减慢窦性心率。普罗帕酮对窦性心率影响不明显。口服普罗帕酮后VPC密度最大下降百分比为1000％，口服氟卡胺为96．0％。结论Ic类抗心律失常药在显著抑制VPC的同时，亦降低HRV，降低迷走神经张力。Objective Enhanced vagal tone has been considered as a protective mecha-nism in cardiovascular diseases. The purpose of this study was to evaluate the effect of Ic antiar- rhythmic agents on heart rate variability (HRV) which indirectly reflects the balance of sympa-thetic - vagal tone. Method The Population studied consisted of 21 patientS with ventricularpremature contractions (VPCs) whose density was less than 1500 per hour on consecutive Holterelectrocardiographic monitoring, including male 12 and female 9, with a mean age of 38. 2 ± 16. 2years. The underlying heart diseases included coronary heart disease in 6 patients, and in the re-maining 15 pateints organic heart disease were not detected. The patients were administered a sin-gle large oral dose of propafenone (400 mg), or flecainide (200 mg) by a randomized single- blind placebo - controlled crossover method. Consecutive Holter electrocardiographic monitoringshave been recorded for 1 hour before and 6 hours after administration to determine the effects ofboth the drugs on HRV and VPCs density. The baseline recordings before administration requiredthe patients to withdraw antiarrhythmic agents for at least 5 half- lives. Result SD, rMSSD andPNN50 significantly decreased after taking 400 mg of propafenone or 200mg of flecainide.fle- cainide significantly increased NN interval. But propafenone had no significant effect on NN inter-val. The maximum percentage or suppression in VPCs density by propafenone or flecainide were100.0% and 96. 0% respectively. Conclusion Propafenone and flecainide not only suppressedVPCs density efficiently, but also decreased HRV significantly indicating that the class Ic antiar-rhythmic agents could attenuate vagal tone.

关 键 词：心率变异性 普罗帕酮 氟卡胺 心律失常 心室 

分 类 号：R969.3[医药卫生—药理学]