摘要
目的 鉴别结内病窦综合征与结外病窦综合征。方法 对临床上疑诊为病窦综合征的３６８ 例患者用食道电生理检查，测定窦房结传导时间（ Ｓ Ａ Ｃ Ｔ）、窦房结恢复时间（ Ｓ Ｎ Ｒ Ｔ）、文氏点、２∶１阻滞点。将３６８ 例分成３ 组：正常为１ 组，结内病窦为２ 组，结外病窦组即迷走神经张力增高为３ 组。结果 １ 组与３ 组年龄相比差异不显著（ Ｐ＞ ０．０５），２ 组年龄明显大于以上两组（ Ｐ＜ ０．０１）。静脉注射阿托品前心率：１ 组＞ ３ 组＞ ２ 组； Ｓ Ａ Ｃ Ｔ、 Ｓ Ｎ Ｒ Ｔ：２ 组＞ ３ 组＞ １ 组；文氏点、２∶１ 阻滞点：３ 组＜ ２ 组＜ １ 组。静脉注射阿托品后：１ 组、３ 组各参数明显改善，３ 组各参数恢复正常。２ 组 Ｓ Ａ Ｃ Ｔ、 Ｓ Ｎ Ｒ Ｔ 仍然明显延长。房室传导功能各组间在注射阿托品后相比差异不显著（ Ｐ＞ ０．０５）。结论 １食道电生理加阿托品试验能准确鉴别结内病窦综合征和结外病窦综合征。２房室结的传导功能与窦房结功能障碍并不直接相关。迷走神经张力增高对房室结的影响更大。
Objectives To differentiate real sick sinus syndrome (SSS) from “psudo sick sinus syndrome”,we examined 368 patients suspected of SSS using esophageal electrophysiology method.Methods All patients were examined including sinoatrial conduction time(SACT),sinus node recovery time(SNRT),Wenckebach block point and 2∶1 block point.368 cases of patients were divided into three groups:normal group(group 1),sick sinus syndrome group(group 2) and vagus nerve hypertonus group(group 3).Results The difference of age was insignificant between group 1 and group 3 ( P >0.05),The group 2 is the oldest patients of the three groups(( P <0.01),heart rate:group 1>group 3>group 2;SACT,SNRT:group 2>group 3>group 1;Wenckebach black point and 2∶1 block point:group 3<group 2<group 1.After atropine given intravenously,all parameters were improved in group 1 and group 3,the parameters in group 3 restored to normal.SACT,SNRT in group 2 were still abnormal.there were no significant changes of atrioventricularconduction function among three group after given atropine.Conclusions 1.The method of esophageal electrophysiological examination+atropine test is useful to differentiate sick sinus syndrome from“psudo sick sinus syndrome”;2.No relations between atrioventricular conduction function and sick sinus syndrome were shown.The influence of vagus nerve hypertonus to A-V node is more prominant than to sinoatrial node.
出处
《临床心电学杂志》
1999年第3期145-147,共3页
Journal of Clinical Electrocardiology
关键词
病窦综合征
植物神经功能
食道电生理
Sick sinus syndrome Vegetative nerve function Esophagus electrophysiology
