多巴酚丁胺负荷对老年劳累性心绞痛P波离散度的影响

Effect of dobutamine stress test on P-wave dispersion in elderly patients with angina pectoris

目的探讨多巴酚丁胺(Dob)负荷对老年劳累性心绞痛P波离散度(Pd)、最大P波(Pmax)的影响。方法老年劳累性心绞痛组29例(心绞痛组)和非冠心病组10例用心电图对照静息与Dob负荷作用达“终止指标”时Pd、Pmax、最小P波(Pmin)、校正P波离散度(Pdc)及Macruz值的变化。结果两组间静息时Pd、Pmax、Pdc、Macruz值比较无统计学差异,但Pmin比较有统计学差异;达“终止指标”时心绞痛组Pd、Pmax、Pdc及Macruz值均明显延长,Pmin缩短,组内及组间比较均有统计学差异。两组用药前后Pd>40ms及Pmax>120ms分布比较心绞痛组分别由3例(10%)和9例(31%)增至18例(62%)和14例(48%),Pd增加例数较非冠心病组增多(P<0.05)。结论老年劳累性心绞痛Dob负荷作用下,心房肌细胞除极的非均质性电活动变化更加明显。

AIM To assess the changes of P-wave dispersion （ Pd ） and P-wave maximum （ Pmax ） in the elderly patients with angina pectoris under grade dobutamine stress test. METHODS the Pd, Pmax, P-wave minimum（Pmin）, correct P-wave dispersion（Pdc）, Pd/P-R were observed and compared during rest and grade dobutamine stress test in 29 cases of effort angina pectoris and 10 normal controls. RESULTS The values of Pd, P Pdo and Pd/P-R under rest showed no significant differences between two groups except for Pmin. Under grade dobutamine stress test when reaching ＂end targets＂, Pd, P Pdc and Pd/P-R of angina pectoris group were longer, while Pn, i. was shorter than those in the normal controls （ P 〈 0.05 ）. When the angina pectoris in the elderly group reached ＂end targets＂, Pd 〉 40 ms in 18 cases （62 % ） and Pmax 〉 120 ms in 14 cases （48 % ）. Compared with normal group, the number of Pd cases increased significantly （ P 〈 0.05 ）. CONCLUSION Under dobutamine stress elderly patients with angina pectoris, dispersion of atrial myocardial cell depolarization increases.