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[注射多巴胺和异丙肾上腺素前后通过心动力学描记法和心电图对冠心病的评估]

[Evaluation of coronary heart disease by kinetocardiography and electrocardiography before and after injection of dopamine and isoproterenol].

作者信息

Strozzi C, Cocco G, Christeller S

出版信息

Arch Inst Cardiol Mex. 1981 Jan-Feb;51(1):89-96.

PMID:7212862
Abstract

Eighty patients with coronary insufficiency, with or without infarction, were studied by kinetocardiography and electrocardiography before and after the infusion of dopamine (40 patients) or isoproterenol (40 patients). Twenty healthy subjects for dopamine and 20 for isoproterenol served as controls. The basal ECG has a moderate (52.5%) sensitivity and a high (92.5%) specificity. KCG-25 has a poor (19,7%) sensitivity and a high (95%) specificity. KCG-45 has a high (76.2%) sensitivity and a moderate (50%) specificity, 25/40 healthy subjects had at least one pathological finding: either the ECG or the KCG-25 or the KCG-45. The mechanisms and the relevance of the false positives of the KCG are reviewed. In spite of different pharmacological properties, there is no statistical difference in the effect of dopamine and isoproterenol on the ECG and KCG. The KCG may be considered equivalent to the ECG, taking into account that it brings different information. The infusion of dopamine or isoproterenol induces dyskinesia in some patients with coronary insufficiency. Only two statistically significant changes were observed: dopamine increases the sensitivity of KCG-25 (up to 44.4%) and the specificity of KCG-45 (up to 95%). In selected cases the infusion of dopamine may be a useful test.

摘要

对80例有或无梗死的冠状动脉功能不全患者在输注多巴胺(40例)或异丙肾上腺素(40例)前后进行了心动图和心电图研究。以20例输注多巴胺的健康受试者和20例输注异丙肾上腺素的健康受试者作为对照。基础心电图的敏感性中等(52.5%),特异性高(92.5%)。KCG - 25的敏感性差(19.7%),特异性高(95%)。KCG - 45的敏感性高(76.2%),特异性中等(50%),40例健康受试者中有25例至少有一项病理检查结果:心电图、KCG - 25或KCG - 45。对KCG假阳性的机制及相关性进行了综述。尽管多巴胺和异丙肾上腺素具有不同的药理特性,但它们对心电图和KCG的影响无统计学差异。考虑到KCG能提供不同的信息,可认为其与心电图等效。输注多巴胺或异丙肾上腺素可导致一些冠状动脉功能不全患者出现运动障碍。仅观察到两项具有统计学意义的变化:多巴胺可提高KCG - 25的敏感性(高达44.4%)和KCG - 45的特异性(高达95%)。在某些特定情况下,输注多巴胺可能是一项有用的检查。

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