盐酸戊乙奎醚在CT血管造影检查中对受检者心率及心率变异性的影响

摘要

目的：观察盐酸戊乙奎醚在心脏螺旋CT血管造影（CTA）检查中对受检者心率及心率变异性（HRV）的影响。方法：选择我院拟行CTA检查的受检者70例，按照随机数字表法分为对照组和观察组，各35例。观察组受检者给予盐酸戊乙奎醚注射液0.8 mg，ivgtt，若30 min内无效则再次追加0.5 mg；对照组受检者给予酒石酸美托洛尔片50 mg，po，若30 min内无效则再次加服20 mg。观察两组受检者常规心电图和动态心电图（DCG）的心率水平、心率变异功率指标、HRV时域参数、心率变化和不良反应发生情况。结果：给药前，以上指标比较差异均无统计学意义（P＞0.05）。观察组受检者给药后1、5、10 min的常规心电图和1、5、10、20 min的DCG心率均明显低于对照组，观察组患者给药后1、5、10、20 min的心率变异总功率（TP）、低频（LF）及给药后5、10、20 min的高频（HF）明显优于对照组，差异均有统计学意义（P＜0.05）。观察组受检者HRV时域参数变化除5 min交感或迷走神经窦性RR间期标准差均值外均较对照组明显升高，将心率控制至70次/min所需时间较对照组明显缩短，CTA检查过程中心率波动次数明显少于对照组，检查成功率明显高于对照组，差异均有统计学意义（P＜0.05）。两组受检者在给药后均未见明显不良反应发生。结论：盐酸戊乙奎醚可明显减慢CTA检查者心率，且控制心率时间较短、维持时间较长、心率波动较小，可用于CTA检查前，安全性较高。%OBJECTIVE:To observe the effects of penehyclidine hydrochloride on heart rate and heart rhythm variability (HRV)during cardiac CT angiography(CTA). METHODS:70 subjects undergoing CTA in our hospital were randomly divided in-to control group and observation group,with 35 cases in each group. Observation group was given Penehyclidine hydrochloride in-jection 0.8 mg,ivgtt,and then given other 0.5 mg if therapy failure within 30 min;control group was given Metoprolol tartrate tab-let 50 mg,po,and then given other 20 mg if therapy failure within 30 min. Heart rate of ECG and DCG,heart rhythm variation power index,HRV time domain parameter,heart rhythm variation,the occurrence of ADR were observed in 2 groups. RESULTS:Before medication,there was no statistical significance in above indexes(P>0.05). The routine electrocardiogram 1,5,10 min af-ter medication and heart rate monitored by DCG 1,5,10,20 min after medication in observation group were significantly lower than in control group,total power(TP),low frequency(LF)and high frequency(HF)of heart rhythm variation 5,10,20 min af-ter medication in observation group were significantly betrer than control group,with statistical significance(P<0.05). The chang-es of HRV time domain parameter in observation group were significantly increased compared to control group,the time of heart rate reaching 70 time/min in observation group was significantly shortened,compared to control group except for average standard deviation of 5 min autonomic nerves or tenth nerves during sinus RR period;the times of heart rate fluctuation in observation group was significantly less than in control group during CTA,and successful rate was significantly higher than control group,with statis-tical significance(P<0.05). No obvious ADR was found in 2 groups after medication. CONCLUSIONS:Penehyclidine hydrochlo-ride can significantly slow heart rate down,have short time of heart rate control,long maintenance time and slight heart rate fluctu-ation,and can be used in CTA with good safety.