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[一种评估抗心律失常药物治疗成功率及个体患者中药物诱导的矛盾性致心律失常效应的新方法]

[A new method for the evaluation of the success of anti-arrhythmic drug therapy and a paradoxical drug-induced arrhythmogenic effect in individual patients].

作者信息

Andresen D, von Leitner E R, Wegscheider K, Schröder R

出版信息

Z Kardiol. 1984 Aug;73(8):492-7.

PMID:6208699
Abstract

The aim of this study was to develop standards to define both antiarrhythmic drug efficacy and a drug-induced arrhytmogenic effect. In 45 patients with frequent and complex ventricular tachyarrhythmias 3 continuous 24-hour Holter recordings were performed. The spontaneous variability of ventricular premature beats and ventricular pairs was calculated using a new statistical method (transformation model). If two 24-hour Holter monitoring periods, one period before and the other with antiarrhythmic therapy, are compared, at least 75% reduction of ventricular premature beats and 90% reduction of ventricular pairs is necessary to be reasonably certain that one is measuring a drug response rather than spontaneous arrhythmia reduction (p less than or equal to 0.05). On the other hand, drug-induced aggravation can be assumed if ventricular premature beats and ventricular pairs have increased by more than 144% and 227%, respectively (p less than or equal to 0.05).

摘要

本研究的目的是制定标准,以界定抗心律失常药物的疗效以及药物诱发的致心律失常作用。对45例频发复杂性室性心律失常患者进行了3次连续24小时的动态心电图记录。使用一种新的统计方法(转换模型)计算室性早搏和室性成对搏动的自发变异性。如果比较两个24小时动态心电图监测期,一个是抗心律失常治疗前的时期,另一个是进行抗心律失常治疗的时期,那么室性早搏至少减少75%且室性成对搏动至少减少90%,才能合理确定所测量的是药物反应而非自发心律失常的减少(p小于或等于0.05)。另一方面,如果室性早搏和室性成对搏动分别增加超过144%和227%(p小于或等于0.05),则可假定为药物诱发的病情加重。

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