静脉注射索他洛尔的临床心脏电生理作用及安全性

Clinical Electrophysiology and Safety of Intravenous Sotalol

目的：研究静脉注射索他洛尔（ｓｏｔａｌｏｌ）对非器质性心脏病患者的心脏电生理作用及安全性。 方法：受试者１０例，１５分钟内静脉注射盐酸索他洛尔０．８ ｍ ｇ／ｋｇ，继以０．６ ｍ ｇ／（ｋｇ·ｈ）匀速静脉泵入。于用药前和静脉泵入１５ 分钟时分别行心脏电生理检查并记录右心室单向动作电位。 结果：用药后窦性周长、窦房结恢复时间和校正的窦房结恢复时间延长（Ｐ＜ ０．０５），窦房传导时间不变。ＡＨ间期及房室结顺传文氏周期延长（Ｐ＜ ０．０１）。心电图ＰＲ、ＱＴ、校正ＱＴ及ＪＴ间期均延长（Ｐ＜ ０．０５），ＱＲＳ间期不变。心房、房室结及心室相对不应期、功能不应期及有效不应期（ＥＲＰ）延长。右心室单向动作电位时间（ＭＡＰＤ９０ ）延长（Ｐ＜ ０．０１），而ＥＲＰ／ＭＡＰＤ９０不变。未发现明显不良反应。 结论：静脉索他洛尔兼有Ⅱ类及Ⅲ类抗心律失常作用，国人对０．８ ｍ ｇ／ｋｇ 耐受性良好。

Objective: To assess the clinical electrophysiologic effects and safety of intravenous sotalol in Chinese patients without organic heart diseases. Methods: Ten subjects were included in this study.Following intravenous administration of sotalol 0 8 mg/kg for 15 minutes,all patients were continued with 0 6 mg/(kg·h)by way of a constant infusion pump.Elecrtophysiologic tests were performed and right ventricular monophasic action potential was recorded before administration and 15 minutes after the infusion of sotalol 0 6 mg/kg. Results: Sinus cycle length,sinus node recovery time and correct sinus node recovery time were increased( p <0 05)after the administration of sotalol.There was no marked change in sinoatrial conduction time. There were significant increases in AH interval and the Wenckebach cycle length of atrioventricular node in anterograde direction( p <0 01).In ECG,the PR interval,QT interval,corrected QT interval and JT interval were increased( p <0 05) and QRS duration unchanged. The relative refractory period, functional refractory period and effective refractory period(ERP)of right atrial,atrioventricular node and right ventricle were increased. The right ventricular monophasic action potential duration at 90% repolarization(MAPD 90 )was prolonged ( p <0 01),but ERP/MAPD 90 of right ventricle remained unchanged.There were no adverse events observed. Conclusion: Intravenous sotalol combines class Ⅱ and Ⅲ antiarrhythmic properties.Sotalol 0 8 mg/kg is well tolerated in Chinese patients.