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[药理学自主神经阻滞对有无窦房结功能障碍患者传导系统的影响]

[The effects of pharmacological autonomic blockade on the conduction system in patients with and without sinus node dysfunction].

作者信息

Tsuchioka Y, Shimizu W, Karakawa S, Mukai J, Nagata K, Yamagata T, Okamoto M, Matuura H, Kajiyama G

机构信息

First Department of Internal Medicine, Hiroshima University School of Medicine.

出版信息

Kokyu To Junkan. 1993 Feb;41(2):153-8.

PMID:8434172
Abstract

Electrophysiological studies were performed in 26 patients with sick sinus syndrome (SSS) and 12 controls before and after pharmacologic autonomic blockade (PAB) with propranolol (0.15 mg/kg) and atropine (0.04 mg/kg). Sinus cycle length (SCL) shortened significantly after PAB in both groups. PA and HV intervals did not change after PAB. AH interval shortened and Wenckebach period increased after PAB in SSS group. Maximum corrected sinus node recovery time shortened in the control group but did not change in the SSS group after PAB. Calculated sinoatrial conduction time shortened after PAB in both groups. Refractory periods of the atrioventricular (AV) node and the ventricle shortened significantly, but those of the atrium did not change after PAB. Linear relations existed between the change of SCL and the change of AH interval and of the Wenckebach period. These results suggested that the autonomic nervous system had the same effects on the sinus and the AV nodes in patients with SSS, and that parasympathetic tone was predominant on the sinus node, the perinodal tissue and the AV node under resting conditions.

摘要

对26例病态窦房结综合征(SSS)患者和12例对照者在使用普萘洛尔(0.15mg/kg)和阿托品(0.04mg/kg)进行药物自主神经阻滞(PAB)前后进行了电生理研究。两组患者在PAB后窦房结周期长度(SCL)均显著缩短。PAB后PA和HV间期未改变。SSS组PAB后AH间期缩短,文氏周期延长。对照组最大校正窦房结恢复时间缩短,但SSS组PAB后未改变。两组PAB后计算得出的窦房传导时间均缩短。房室(AV)结和心室的不应期显著缩短,但PAB后心房不应期未改变。SCL的变化与AH间期和文氏周期的变化之间存在线性关系。这些结果表明,自主神经系统对SSS患者的窦房结和房室结有相同的影响,并且在静息状态下,副交感神经张力在窦房结、结周组织和房室结中占主导地位。

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