Wang Liuyi, Wang Lixia, Zhang Yongzhen, Zhang Bingyong, Chen Mingzhe
Department of Cardiology, Henan Provincial People's Hospital, Zhengzhou 450003, China.
Chin Med J (Engl). 2002 May;115(5):770-2.
To investigate whether transdermal scopolamine increased cardiac vagal activity in patients during the acute phase of myocardial infarction.
30 patients with a first acute myocardial infarction and preserved sinus rhythm who were on no drug that could influence the sinus node were randomly assigned to either treatment group or placebo group. Measures of heart rate variability (HRV) in patients given drug or placebo were obtained by digital 24 hour Holter recording before and after treatment. Baroreflex sensitivity was performed using the phenylephrine method.
No significant differences was found in the indices of the time domain and the frequency domain in both groups before treatment. Patients with transdermal scopolamine showed a significant increase in the standard deviation of normal RR intervals (SDNN), standard deviation of all five min mean normal RR intervals (SDANN), root mean square of differences of successive normal RR intervals (rMSSD), total power (TP, 0.000. - 0.40 Hz), low frequency peak (LF, 0.040 - 0.15 Hz), high frequency peak (HF, 0.15 - 0.40 Hz), and Baroreflex sensitivity after treatment (P < 0.05 - 0.01). These indices did not change in patients given placebo.
Low doses of transdermal scopolamine safely increase cardiac parasympathetic activity and improve autonomic indices in patients with acute myocardial infarction.
探讨透皮给予东莨菪碱是否能增加心肌梗死急性期患者的心脏迷走神经活动。
选取30例首次发生急性心肌梗死且窦性心律正常、未服用影响窦房结药物的患者，随机分为治疗组和安慰剂组。通过数字式24小时动态心电图记录，获取给药或安慰剂患者治疗前后的心率变异性（HRV）指标。采用去氧肾上腺素法测定压力反射敏感性。
治疗前两组患者时域和频域指标均无显著差异。给予透皮东莨菪碱的患者治疗后正常RR间期标准差（SDNN）、每5分钟平均正常RR间期标准差（SDANN）、连续正常RR间期差值的均方根（rMSSD）、总功率（TP，0.000 - 0.40 Hz）、低频峰值（LF，0.040 - 0.15 Hz）、高频峰值（HF，0.15 - 0.40 Hz）及压力反射敏感性均显著增加（P < 0.05 - 0.01）。给予安慰剂的患者这些指标未发生变化。
低剂量透皮东莨菪碱可安全增加急性心肌梗死患者心脏副交感神经活动并改善自主神经指标。
