摘要
目的 :评价频率对地尔硫心脏电生理作用的影响。 方法 :对 17例患者进行电生理检查 ,分析应用地尔硫前后在不同频率情况下房室结的电生理变化。 结果 :地尔硫不影响窦性心律周长、窦房结恢复时间、HV间期 ,但房室结文氏周长由 312 .2± 18.6 ms延长到40 8.3± 17.5 ms(P<0 .0 1)。在慢频率心房起搏时 ,地尔硫使房室结有效不应期 (AVNERP)和 AH间期延长 ,延长量分别为 44 .2± 10 .8ms和 19.2± 6 .7ms。在快频率心房起搏时 ,AVNERP和 AH延长更为显著 ,分别为 91.7± 14ms和47.5± 10 .6 ms(P<0 .0 1,与慢频率相比 )。地尔硫延长 AVNERP的程度大于 AH间期 ,在快频率时该作用更为明显。 结论 :地尔硫对人体房室结功能影响具有快频率依赖性特点 ,这种作用使其在心动过速时选择性抑制房室结。
Objective:To evaluate the importance of heart rate in modulating the electrophysiological effects of diltiazem in human. Methods:Electrophysiological parameters of atrioventricular node were analysed at multiple atrial rates before and after administration of diltiazem. Results:Electrophysiological studies were performed in 17 patients.Sinus cycle length,sinus node recovery time(SNRT) and HV interval were unaffected by diltiazem infusion,but wenckebach cycle length(WCL) were prolonged from 312 2±18 6 ms to 408 3±17 5 ms ( p <0 01).During atrial paced rhythm at long cycle length,diltiazem caused increase in A V nodal effective refractory period(AVNERP) and AH(44 2±10 8 ms and 19 2±6 7 ms,respectively).Drug effects were far greater at short cycle length,91 7±14 0 ms for AVNERP and 47 5±10 6 ms for AH ( p <0 01 versus values at long cycle length).Effects of diltiazem on AVNERP exceeded those on AH. Conclusion:Diltiazem depresses human atrioventricular nodal function in frequency dependent manner,these effects lead to highly selective depression of AV nodal function during tachycardias.
出处
《中国循环杂志》
CSCD
北大核心
2001年第1期10-11,共2页
Chinese Circulation Journal
