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静脉注射腺苷在诊断病态窦房结综合征中的价值(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2003年第2期
页码:
124-125,128
栏目:
临床研究
出版日期:
2003-03-01

文章信息/Info

Title:
Utilization of intravenous adenosine as a noninvasive diagnostic tool for sick sinus syndrome
作者:
张文君; 王兴元; 张清; 贾国良; 李兰荪; 王海昌; 张殿新; 何争
第四军医大学西京医院心血管内科,陕西 西安 710032
Author(s):
ZHANG Wen-jun; WANG Xing-yuan; ZHANG Qing; JIA Guo-liang; LI Lan-sun; WANG Haichang; ZHANG Dian-xin; HE zheng
Department of Cardiology,Xijing Hospital,Fourth Military Medical University,Xi'an,Shaanxi 710032,Chin
关键词:
病态窦房结综合征; 食道电生理检查; 腺苷 中图
Keywords:
sick sinus syndrome; esophagus pacing; adenosin
分类号:
R541.74
DOI:
-
文献标识码:
A
摘要:
目的:检查静脉注射腺苷在诊断病态窦房结综合征(SSS)中的价值。方法:比较100例SSS患者和100例对 照组经食管电生理检查(EP)测得的校正窦房结恢复时间(CSNRT)以及弹丸式注射腺苷(0.15mg/kg)后的 CSNRT(ADO:CSNRT)。结果:如果将CSNRT>550ms作为诊断SSS的标准,那么ADO:CSNRT的敏感性和特 异性分别为80%,97%;而EP时CSNRT的敏感性和特异性分别为70%,95%。如果将两者相结合,则敏感性为 100%。两组间的CSNRT和ADO:CSNRT存在着显著差异(均P<0.01)。结论:ADO:CSNRT是诊断SSS特异 而敏感的指标,与EP检查相当,对疑是SSS患者进行EP前应首先进行腺苷注射检查。
Abstract:
AIM:To determine the diagnostic value of intravenous adenosine in patient swith sick sinus syndrome(SSS).METHODS:We compared the corrected sinus node recovery time(CSNRT) in esophagus pacing(EP) with the lengthening of the sinus cycle length(ADO:SCL) corrected to the basic cycle length(ADO:CSNRT) after administration of anbolus of adenosine (0.15mg/kg) in 100 patient swith clinical SSS(GroupI) and 100 control patients (GroupII).RERULTS:With 550 ms of ADO:CSNRT (or CSNRT) as an indicator of sinus node dysfunction,theADO:CSNRThadasensitivityof80% andspecificityof97% forthedetection of SSS,compared with those 70% and 95% for CSNRT in EP. When combined,the 2 tests had a sensitivity of 100%.There was a significant difference both in CSNRT between GroupI (1847 ±1824) and GroupII (356±168) and in ADO:CSNRT between GroupI (1169±1001) and GroupII (273±591). CONCLUSION: We conclude that ADO:CSNRT is a sensitive and specific test for SSS that equals EP and could be considered as an alternative to EP inpatients with suspected SSS

参考文献/References

[1]Benditt DG,Sakaguchi S,Goldstein MA,et al.Sinus node dysfunction : pathophysiology, clinical features,evaluation and treatment[A].ZipesDP,Jalife J.Cardiac electrophysiology:from cellto bedside [M ]. Philadelphia: WB Saunders Company,1995.1215-1240.

[2] Resh W,Feuer J,Wesley RC,et al.Intravenousadenosine:a noninvasive diagnostic test for sick sinus syndrome [J].PACE,1992,15:2068-2073.

[3]Brignole M,Menozzi C,Alboni P,et al. The effect of exogenous adenosine in patients with neutrally mediated syncope and sick sinus syndrome[J].PACE,1994,17:2211-2216.

[4]Josephsom ME. Sinus node function [A].Josephson ME.Clinical cardiac electrophysiology: techniques and interpretations [M]. 2nd ed. Philadelphia:Lea& febiger,1993.71-95.

[5]Resh W,Feuer J,Wesley RC,et al. Intravenous adenosine:a noninvasive diagnostic test for sick sinus syndrome [J]. PACE, 1992,15:2068-2073

备注/Memo

备注/Memo:
收稿日期：2001-7-10.
更新日期/Last Update: 2003-03-01