儿童房室结双径路电生理特性与房室结折返性心动过速的关系  

Relationship between the electrophysiological features of the dual atrioventricular nodal pathways and the atrioventricular nodal reentry tachycardia in children

作　　者：安金斗[1] 张彦萍[1] 王志远[1] 刘松茂[1] 高铁铮[1] 

机构地区：[1]郑州大学第一附属医院儿科,郑州450052

出　　处：《郑州大学学报（医学版）》2004年第3期487-489,共3页Journal of Zhengzhou University(Medical Sciences)

摘　　要：目的 :探索房室结双径路 (DAVNP)的电生理特性与房室结折返性心动过速 (AVNRT)间的关系。方法 :采用经食管左心房调搏检查术 (TEAP)对 71例DAVNP儿童实施S1 S2刺激 ,测定房室结快径路前传时间 (FP)、有效不应期 (FPERP)、功能不应期 (FPFRP)、相对不应期 (FPRRP)、房室结慢径路前传时间 (SP)及有效不应期 (SPERP)、功能不应期 (SPFRP)及S2 R跳跃幅度 ,计算SP与FP间、FPERP与SPERP间、SPFRP与FPFRP间的差值。诱发AVNRT后 ,计算其频率。结果 :71例经TEAP诱发AVNRT发作 2 5例 ,均为慢 快型 ,诱发率为 35 .2 % ;诱发与未诱发AVNRT组SP及不应期、S2 R跳跃、FP及不应期、SP -FP、FPERP -SPERP比较 ,差异无统计学意义 ;2组间SPFRP -FPFRP差异有统计学意义 ,P <0 .0 1 ;诱发AVNRT组SPFRP均大于FPFRP ,而未诱发AVNRT组 1 2例SPFRP小于FPFRP。结论 :SPFRP -FPFRP的值越大的DAVNP越容易发生AVNRT ,SPFRP小于FPFRP的DAVNP儿童不容易发生AVNRT。Aim:To investigate the relationship between the electrophysiological features of dual atrioventricular nodal pathways(DAVNP) and atrioventricular nodal reentry tachycardia(AVNRT),and to find the signs which could predicate the occurrence of AVNRT.Methods:A total of 71 children with DAVNP were stimulated in S1 S2 manner by transesophageal atrial pacing(TEAP).Electrograms were recorded on a single channel photographic recorder with paper speed 25 mm/sec.The fast pathway(FP) conducting time of the atrioventricular node,FP effective refractory periods(ERP),FP functional refractory periods(FRP),FP relative refractory periods(RRP), slow pathway(SP) conducting time of the atrioventricular node,SPERP,SPFRP and jumping height of S 2 R intervals were measured. The differences between SP and FP,FPERP and SPERP,SPFRP and FPFRP were calculated.Results:Out of 71 children with DAVNP,25(35.2%) occurred AVNRT induced by TEAP.The differences between SPFRP and FPFRP in the AVNRT induced group were (69.00±31.10) ms, and that in the uninduced group was (22.57±57.90) ms,these was statistical significance( t =3.37, P <0.01).The SPFRP was longer than the FPFRP in all cases of the induced group,but the SPFRP was shorter than the FPFRP in 12 cases of the uninduced group.Conclusion:The much larger the difference between SPFRP and FPFRP of DAVNP is, the more easily AVNRT occurred.The children with DAVNP are not susceptible to AVNRT when the SPFRP is shorter than the FPFRP.

关 键 词：房室结双径路 房室结折返性心动过速 儿童 

分 类 号：R725.4[医药卫生—儿科]