摘要
目的 研究室性心律失常患者使用抗心律失常药物发生致心律失常作用对 QT间期离散度的变化。方法 对 346例室性心律失常患者使用抗心律失常药物 ,测量治疗前后 QTcd及动态心电图 ,并与10 2例健康人进行对照。结果 室性心律失常组治疗前与对照组间 QTcd有显著性差异 (P<0 .0 1) ,治疗后好转组 QTcd明显降低 ,与对照组比较无明显差异 (P >0 .0 5 ) ,无效组 QTcd无明显变化 ,致心律失常组QTcd反而升高。QTcd在服药后 3～ 4天开始变化 ,5～ 7天时变化幅度最大 ,12～ 14天变化幅度最小。不同药物致心律失常发生率不同 ,乙吗噻嗪致心律失常发生率最高 (14.6 % ) ,高于美西律 (6 .1% ) ,与普罗帕酮(8.8% )比较无显著差异 (P>0 .0 5 ) ,美西律与普罗帕酮比较亦无显著差异。乙吗噻嗪、美西律、普罗帕酮用药二周后 QTcd比较无显著差异。结论 QTcd值的变化是监测抗心律失常药物致心律失常作用的灵敏而重要的指标。
ObjectiveTo investigate the changes of QTc dispersion(QTcd) in patients with proarrhythmic effect of antiarrhythmic drug.Methods 346 ventricular arrhythmic (VA) patients were studied and 102 healthy people used as control.QTcd was measured before and after treatment.Results QTcd was significantly prolonged in patients with VA before treatment compared with control group ( P <0.01),QTcd decreased significantly ( P< 0.01) in effective group,and QTcd remained unchanged in uneffective group,and QTcd increased significantly in group with proarrhythmic effect.QTcd began to change from the 3d day to the 4th day,the change of QTcd was largest from the 5th day to the 7th day,it was the smallest from the 12th day to the 14th day.The rate of proarrhythmia of different drug was different.There was no difference between ethmozine(14.6%) and propafenone(8.8%),between mexiletine(6/1%) and propafenone.There were no difference among them on QTcd after treatment for two weeks.Conclusion the change of QTcd was sensitive and important indices of monitored the proarrhythmia of antiarrhythmic drug.
出处
《临床心电学杂志》
2000年第4期209-211,共3页
Journal of Clinical Electrocardiology
