摘要
目的:为了探讨变异型心绞痛后再灌注性心律失常的特点。方法:对38例变异型心绞痛患者发作后的再灌注性心律失常采用CM_5和CM_(5VF)导联系统进行Holter监测24小时。观察了舌下含服硝苯地平或硝酸酯类药物,服用美西律及心功能对心律失常发生的影响。用χ~2检验处理分析再灌注性心律失常发生率的差别。结果:检出的38例变异型心绞痛患者中,20例发生再灌注性心律失常,发生率为53%。胸痛持续5分钟以下者,其发生率为41%;5～10分钟者为50%,10～15分钟者为71%。其类型以频发室性早搏多见(85%),其次是加速性室性自主心律(60%)与短阵性室性心动过速(45%),1例发生心室颤动。含眼硝苯地平10～20 mg与含服硝酸酯类药物者再灌注性心律失常发生率分别为28%和75%(P<0.05),服用美西律与未服用者分别为46%和59%(P>0.05),心功能正常者与心功能不全者分别为43%和80%(P<0.05)。结论:变异型心绞痛发作时,胸痛持续时间越长,再灌注性心律失常发生率越高,程度越重;含服硝苯地平可显著降低其发生率;抗心律失常药物不能降低其发生率;心功能差者其发生率亦增高。
Objective: To study the characteristics of reperfusion arrhythmia (RA) following variant angina (VA). Methods: The lead systems of CM_5 and CM_(aVF) of 24h Holter monitoring were used in the study of RA in 38 patients following VA. The effects of sublingual nifedipine or nitroglycerin, mexiletine treatment as well as cardic function on the incidence of RA were also observed. The incidence of RA was statistically handled by x^2 test. Results: 20 of the 38 patients (53%) had RA, the incidence of which was 41% in patients with chest pain<5 minutes; 50% for 5-10 minutes; 71% for 10-15 minutes. The types of RA were ventricular premature beats (85%), acceleratory idioventricular rhythm (60%), paroxysmal ventricular tachycardia (45% ), ventricular fibrillation and sinus arrest in several cases. The incidences of RA were 28% and 75% (p<0.05), respectively in patients with sublingual nifedipine (10-20 mg) or nitroglycerin, 46% and 59% (p>0.05), respectively in those treated with mexiletine or not treated with mexiletine, 43% and 80% (p <0.05), respectively in whose with normal or abnormal cardiac function. Conclusions: During the attack of VA, the longer the chest pain lasted, the higher the incidence of RA and the more serious the RA. The incidence of RA could be reduced remarkably by sublingual nifedipine, but not by anti-arrhythmic drugs. The incidence of RA in patients with cardiac failure was also higher than those with normal cardic function.
出处
《中国循环杂志》
CSCD
1996年第3期144-147,共4页
Chinese Circulation Journal
