SSS患者窦房结恢复时间曲线分布的意义

Distribution curve of sinoatrial recovery time in patients with sick sinus syndrome

采用经食道心房调搏技术测定６５例病态窦房结综合症（ＳＳＳ）病人和２９例窦性心动过缓（ＳＢ）病人于不同起搏频率时窦房结恢复时间（ＳＮＲＴ）值，并分析两者的相关关系。结果发现：ＳＳＳ病人起搏频率与ＳＮＲＴ值有８种相关图形，不同起搏频率ＳＮＲＴ值曲线分布弥散，多为双峰甚至三峰，各病人ＳＮＲＴ最大值（ＳＮＲＴｍａｘ）与ＳＮＲＴ最小值（ＳＮＲＴｍｉｎ）差值大，其中５９例差值＞５００ｍｓ，平均８９９．５±９８．０ｍｓ，最大差值６５４０ｍｓ。而单纯ＳＢ病人ＳＮＲＴ分布曲线光滑、弥散度小，多为单峰。４４．６％ＳＳＳ病人和４１．４％ＳＢ组病人最适起搏频率（ＰＨＲｐ）在１００～１３０ｂｐｍ之间，而有１３．８％ＳＳＳ病人和６．９％ＳＢ病人ＰＨＲｐ＜７０ｐｍ。

Sinoatrial node recovery times (SNRT) were mesured with transesophageal atrial pacing (TEAP) in different pacing heart rates (PHR) in 65 patients with sick sinus syndrome (SSS),and 29 patients with sinus bradycardia (SB) as a control group. The results showed that the distribution curve of SNRT was dispersed in patients with SSS and often had two or three peaks. There was a great difference between the maximum value and the minimum value of SNRT in each patient. Among them,the difference was larger than 500 ms in 59 cases with a mean of 899.5±98.0ms. The maximum difference was 6540ms. In contrast,the curve in SB patients was rather smooth with little dispersion,and often had a single peak. The optimal pacing frequency ranged from 100 to 130 bpm in 44. 6% of patients with SSS and 41. 4% of patients with SB,while it was less than 70 bpm in 13. 8% of patients with SSS and 6. 9%patients with SB.