异丙肾上腺素与阿托品在食管心房调搏中诱发心动过速效果观察  

Effect observation of isoprenaline and atropine inducing paroxysmal supraventricular tachycardia in transesophageal atrial pacing

作　　者：吴蕊 闫菲 吕亚峰 高玲 王珏 吴金涛 WU Rui;YAN Fei;LYU Ya-feng;GAO Ling;WANG Jue;WU Jin-tao(Heart Centre of Henan Provincial People′s Hospital,Zhengzhou 450008,Henan Province,China)

机构地区：[1]阜外华中心血管病医院河南省人民医院心脏中心

出　　处：《新乡医学院学报》2019年第9期851-854,共4页Journal of Xinxiang Medical University

基　　金：河南省科技攻关计划项目(编号:112102310665)

摘　　要：目的观察异丙肾上腺素和阿托品在经食管心房调搏(TEAP)检查中诱发患者心动过速的差异,并分析其相关机制。方法选择疑似为阵发性室上性心动过速(PSVT)患者420例为研究对象,根据诱发药物分为异丙肾上腺素组(n=240)和阿托品组(n=180)。2组患者均行TEAP检查以诱发PSVT(基础诱发),基础诱发未成功者分别给予异丙肾上腺素和阿托品进行诱发,比较2组患者给药后TEAP对PSVT的诱发成功率、诱发方式及诱发PSVT类型。结果给药后异丙肾上腺素组和阿托品组患者PSVT诱发成功率分别为54.59%(101/185)、44.20%(61/138);异丙肾上腺素组患者PSVT诱发成功率显著高于阿托品组(χ^2=10.230,P<0.05)。异丙肾上腺素组患者中,S1S1和S1S2诱发例数分别为64例(63.37%)和37例(36.63%);阿托品组患者中,S1S1和S1S2诱发例数分别为38例(62.30%)和23例(37.70%);2组患者S1S1和S1S2诱发例数比较差异均无统计学意义(χ^2=0.256、1.047,P>0.05);2组患者采用S1S1诱发例数均显著高于S1S2诱发例数(χ^2=7.377、8.619,P<0.05)。异丙肾上腺素组患者慢快型房室结折返性心动过速(S-FAVNRT)及室性心动过速(VT)诱发率高于阿托品组,房室折返性心动过速(AVRT)及房性心动过速(AT)诱发率低于阿托品组(P<0.05)。对AVRT亚型进行分析发现,异丙肾上腺素组患者中右侧旁路参与的房室折返性心动过速(OAVRT-R)诱发率高于阿托品组,左侧旁路参与的房室折返性心动过速(OAVRT-L)诱发率低于阿托品组(P<0.05);2组患者逆向型房室折返性心动过速(A-AVRT)诱发率比较差异无统计学意义(P>0.05)。结论异丙肾上腺素与阿托品均可提高心动过速的诱发率,但诱发的PSVT类型有所不同,此差异与2种药物作用机制的不同有关。Objective To observe the differences of isoprenaline and atropine inducing paroxysmal supraventricular tachycardia(PSVT) in transesophageal atrial pacing(TEAP),and analyze its possible mechanism. Methods Four hundred and twenty patients with suspected PSVT were divided into isoproterenol group ( n =240) and atropine group ( n =180) according to inducing drugs.The TEAP was performed in both group to induce the PSVT (basic induction).Then the unsuccessful patients were induced by isoprenaline and atropine respectively.The success rate,mode and type of TEAP inducing PSVT after administration were compared between the two groups. Results The success rate of induction of PSVT in isoproterenol group and atropine group were 54.59%(101/185) and 44.20%(61/138),respectively;the induced success rates of patients in the isoproterenol group was significantly higher than that in the atropine group (χ 2=10.230, P <0.05).In isoprenaline group,the number of patients with PSVT induced by S 1S 1 and S 1S 2 was 64 (63.37%) and 37 (36.63%) respectively;while in atropine group,the number of patients with PSVT induced by S 1S 1 and S 1S 2 was 38 (62.30%) and 23 (37.70%) respectively.There was no significant difference in the proportion of PSVT induced by S 1S 1 and S 1S 2 between the two groups (χ 2=0.256,1.047;P >0.05);the proportion of PSVT induced by S 1S 1 was significantly higher than that induced by S 1S 2 in the two groups (χ 2=7.377,8.619;P <0.05).The induction rates of slow and fast atrioventricular nodal reentrant tachycardia (S-F AVNRT) and ventricular tachycardia (VT) in isoproterenol group were higher than those in the atropine group,but the induction rates of atrioventricular reentrant tachycardia (AVRT) and atrial tachycardia (AT) were lower than those in the atropine group ( P <0.05).The analysis of AVRT subtypes showed that the induction rate of orthodromic arioventricul reentrant tachycardia from right bypass (OAVRT-R) in isoproterenol group was higher than that in the atropine group,the induction rate of orthodrom

关 键 词：异丙肾上腺素 阿托品 食管心房调搏 阵发性室上性心动过速 

分 类 号：R540.4[医药卫生—心血管疾病]