【摘要】 目的分析心肌灌注显像时阿托品-4min腺苷负荷试验中血流动力学及心电图改变,并与4min、6min腺苷负荷试验进行比较。方法将83例研究对象分为3组:组1为阿托品-4min腺苷负荷试验组,共28例;组2为4min腺苷负荷试验组,共27例;组3为6min腺苷负荷试验组,共28例。组1在注射腺苷前10min静脉注射阿托品0.5mg。三组病例分别经肘静脉用注射泵持续注入腺苷,剂量为0.14mg·kg-1·min-1,用药时间为4min、4min和6min。结果①三组病例在注射腺苷3min、停药时分别与基础状态比较,血流动力学各指标变化组内比较差异有统计学意义(P<0.001),组间差异无统计学意义。②房室传导阻滞和ST段改变在三组病例中的发生率分别为0、4%、7%和32%、33%、36%,组间比较差异均无统计学意义。结论阿托品-4min腺苷负荷试验与4min腺苷负荷试验、6min腺苷负荷试验相比,具有对心脏产生负荷、引起血流动力学变化以及相应心电图改变相同的作用,而房室传导阻滞的发生率却相对较低,有利于提高受检者对试验的耐受。更多还原

【Abstract】 Objective To analyze the changes of hemodynamics and ECG during atropine-four-minute adenosine myocardial perfusion imaging.Methods Three groups:atropine-four-minute adenosine infusion(group 1),four-minute adenosine infusion(group 2)and six-minute adenosine infusion(group 3).0.5 mg atropine was injected intravenously ten minutes before adenosine infusion in the group 1.In three groups,adenosine was infused at a rate of 0.14 mg·kg-1·min-1 intravenously for four,four and six minutes.Three minutes after adenosine infusion,740 MBq of 99Tcm-MIBI were injected intravenously.SPECT myocardial imaging acquisition was obtained 1.5 hours after adenosine infusion.Results ⑴Some changes of hemodynamics appeared 2-3 minutes after adenosine infusion in three groups:blood pressure(BP)has a drop and heart rate(HR),rate-pressure product(RPP)increased.Among the three groups,the changes was not significantly different(P<0.05).⑵Atrioventricular block and the changes of ST segment in three groups occurred 0%,4%,9% and 32%,32%,35%,respectively.(P=NS)Conclusion In comparison with four-minute infusion and six-minute infusion,atropine-four-minute adenosine infusion has similar effect on inducing the changes of hemodynamics and ECG,has lower incidence of atrioventricular block and helpful to enhance the tolerance of patients.更多还原