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|本期目录/Table of Contents|

尖端扭转型室性心动过速的快速识别和治疗(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2005年第1期
页码:
55-57
栏目:
临床研究
出版日期:
2005-01-05

文章信息/Info

Title:
The rapid identification and therapy of torsade de points
作者:
史俊忠;  杜日映;  杨欣国;  李志立; 柳荫
第四军医大学唐都医院心内科， 陕西 西安 710038
Author(s):
SHI Junzhong; DU Riying; YANG Xinguo; LI Zhili; LIU Yin
Department of Cardiology, Tangdu Hospital, Fourth Military Medical University, Xi’an, Shaanxi 710038,China
关键词:
尖端扭转性室性心动过速; QT间期; 联律间期; 治疗
Keywords:
torsade de points;  QT interval;  coupling intervals;  therapy
分类号:
R541.71
DOI:
-
文献标识码:
A
摘要:
目的 分析快速识别和治疗尖端扭转性室性心动过速（Tdp）的方法及疗效。方法 对36例Tdp的临床资料、心电图特征及治疗情况进行分析。结果 先天性长QT间期综合征（LQTS）伴发Tdp者3例，获得性长QT间期致Tdp（LQTT）者29例，伴有极短联律间期的Tdp 4例。先天性LQTS治疗的重点是使用β受体阻滞剂；获得性LQTT治疗的重点是去除病因，增快心率，纠正心室复极异质性；伴极短联律间期的Tdp治疗的重点是使用钙拮抗剂。结论 尽快获取病史和诱发因素，详细甄别心电图和针对性治疗，对Tdp的快速识别和及时处理具有重要意义。
Abstract:
AIM To discuss the method of rapid identification and therapy of Torsade de points(Tdp). METHODS The clinical data, ECG characteristics and therapeutics course in 36 Tdp patients were analysed . RESULTS Of all the cases,3 were herited LQTS with Tdp, 29 were acquired LQTT and 4 were Tdp with very short coupling intervals. The emphasis in the therapy of inherited LQTS was the use of βadrenoceptor blocking agents. The emphasis in the therapy of ALQTT was to get rid of its pathogeny, to accelerate HR, and to correct the ventricular repolarization heterogenesis .The emphasis in the therapy of Tdp with very short coupling intervals was the use of Calcium channel antagonists. CONCLUSION For the rapid identification and timely therapy of Tdp, it is of great significance to get the medical history and inducement as soon as possible, to identify the ECG in detail and to treat the patients pertinently.

参考文献/References

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［3］中华心血管病杂志编辑委员会心律失常对策专题组.心律失常的临床对策［J］.中华心血管病杂志，1993，21:7-8.

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［5］Wabg Q,Current ME,Splawski I,et al. Positional cloning of a novel potassium channel gene:KVLQTIK mutations cause cardiac arrhythmias［J］. Nat Genet, 1996，12:17-23.

［6］Kuo CS,Munakuat K,Reddy CP,et al. Characteristics and possible mechanism of ventricular arrhythmia dependent on the dispersion of action potential duration［J］. Circulation,1983,67:1356-1367.

［7］Akar FG,Yan GX, Antzelevitch C.et al.Unique topographical distribution of M cells underlies reentrant mechanism of torsade de points in the long QT Syndrome［J］. Circulation,2002,105(10):1247-1253.

［8］史俊忠，杜日映，张宁仔，等. 获得性多形性室性心动过速伴发于QT间期延长15例临床分析［J］. 临床内科杂志，1997,14（1）：18-19.

备注/Memo

备注/Memo:
收稿日期：2003-11-01.
更新日期/Last Update: 2010-01-05