东莞市青少年显著性窦性心动过缓的无创性电生理探究  

The non-invasive electrophysiology of the juvenile with significant sinus bradycardia in Dongguan

作　　者：吕洪雪 叶小汉 王婷 LV Hong-xue YE Xiao-han WANG Ting(Department of Cardiology, Dongguan Hospital of Traditional Chinese Medicine of Traditional Chinese Medicine University Of Guangzhou, Dongguan 523000, Chin)

机构地区：[1]广州中医药大学附属东莞中医院心内科,广东东莞523000

出　　处：《广东医科大学学报》2017年第2期170-173,共4页Journal of Guangdong Medical University

摘　　要：目的探讨东莞市青少年显著性窦性心动过缓(OSB)的临床电生理特点。方法选取本院就诊的50例有症状青少年OSB患者(A组)、50例无症状青少年OSB患者(B组)以及50例健康志愿者(C组)作为研究对象。采用心电图、24h动态心电图、经食管心房调搏术及阿托品试验观察上述3组的临床电生理特点。结果早期复极综合征(ERS)患者在A、B、C 3组中分别为22、19、6例,A、B组的ERS发生率均高于C组(P<0.01)。A、B组平均心率均<60次/min,且显著低于C组(P<0.05)。A、B两组间的静息心率、平均心率、最慢心率、最快心率比较差异无统计学意义(P>0.05)。A、B、C 3组心率变异性时域指标呈递减趋势(P<0.05)。经食管心房调搏术显示,A、B组中SACT、SNRT、c-SNRT、AVNRF高于C组(P<0.05),但A、B两组间比较差异无统计学意义(P>0.05)。注射阿托品后,A组中达峰值心率时间(Tpeak)显著长于B、C两组(P<0.05),A、B组中c-SNRT高于C组(P<0.05),B组中AVNRF高于A、C组(P<0.05)。结论本市青少年OSB患者电生理改变与高迷走神经张力明显有关,对迷走神经改变适应性慢可能为其不适症状的主要原因。Objective To explore the clinical electrophysiological characteristics of the juveniles with obvious sinus bradycardia （OSB） in Dongguan. Methods Fifty symptomatic juveniles with OSB （Group A）, fifty asymptomatic juveniles with OSB （Group B） and fifty healthy volunteers （Group C） in our hospital were collected as research subjects. The ECG, 24 h DCG, trans-esophageal atrium pacing （TEAP） and atropine test were used to detect the clinical electrophysiological characteristics of above three groups. Results There were 22, 19 and 6 cases with early repolarization syndrome （ERS） in Group A, B and C, respectively. The mean heart rate in Group A and B was less than 60 bpm and significantly slower than that in Group C （P〈0.05）. There was no significant difference between Group A and B in terms of resting heart rate, mean heart rate, minimum and maximum heart rate. The index of heart rate variety （HRV） in the three groups showed a tendency of decrease （P〈0.05）. TEAP revealed that Group A and B had a higher SACT, SNRT, c-SNRT and AVNRF than Group C （P〈0.05）, but there was no statistical difference between Group A and B （P〉0.05）. After injection with atropine, the time to reach the peak heart rate （Tpeak） in Group A was significantly more than that in Group B and C （P〈0.05）, the c-SNRT in Group A and B was higher than that in Group C （P〈0.05）, and the AVNRF in Group 13 was higher than that in Group A and C （P〈0.05）. Conclusion The electrophysiological changes of the juveniles with OSB in Dongguan are significantly related with high vagus tension, and a slow reaction to the change of vagus tension may the main cause.

关 键 词：显著性窦性心动过缓 心电图 食管心房调搏 阿托品试验 

分 类 号：R541.7[医药卫生—心血管疾病]