低交感张力型窦房结功能障碍

Hyposympathetc sinus node disfunction

目的 研究交感神经张力低下对窦房结功能的影响。方法 回顾性分析 5 2 8例窦性心动过缓病人运动试验、阿托品试验、异丙肾试验、Holter监测、固有心率测定和经食道心房调搏资料。结果 5 2 8例中 ,2 2例 (3.89% )阿托品试验阴性 ,而运动及异丙肾试验阳性 ,固有心率实测值低于预测值 ,经食道心房调搏有不同程度的窦房结恢复时间和窦房传导时间延长。结论 病态窦房结综合征 (sicksinussyndrome ,SSS)可由窦房结或其周围组织器质性损害所致 ,但亦可为心脏自主神经功能障碍引起 ,其中少数低交感张力型SSS病情有恶化趋势 ,需安装起搏器治疗 ,应引起临床重视。

Objective: To determine the effect of hyposympathotonicity on sinusnode function.Methods: 528 cases of sinus bradycardia were reviewed had undergone the 12 lead ECG,exercise,atropine,isoprenaline tests and 24 hour dynamic ECG recording.In some patients,intrinsic heart rate (IHR)evaluation and atrial pacing through esophagus weve made.Results: 22 of 528 patients (3 89%) weve negative in atropine tests, but positive in exercise and isoprenaline tests.The experimental Value of IHR Was lower than the predicted prolonged sinus node recoyering time(SNRT)and sino atrial conduction time(SACT)occurred in somedegree in these patients by transesophgeal atrial pacing.Conclution: Sick sinus syndrome(SSS) is usually caused by organic injury of sinoatrial node and the surrounding tissues,but in some cases autonomic nerve disfunction,especially the hyposympatho tonicity may become dominant in the development of the sick sinus syndrome.