国产盐酸艾司洛尔的电生理学特性的研究

Electrophysiologic study of the effects of esmolol hydrochloride produced by our country

目的 :观察国产盐酸艾司洛尔对中国人的电生理学效应 ,以评价其临床应用前景。方法 :对 2 0例行心内电生理检查的患者分别于静注艾司洛尔前及注射过程中测定各项心脏电生理指标 ,包括窦房结、心房、房室结、心室以及希 -浦系功能 ,同时 ,观察血压、心率与心电图各项参数的变化。结果 :用药时窦房结恢复时间、心房有效不应期、房室结有效不应期、房室结前传文氏点、A- H间期明显延长 ,而窦房结传导时间、P- A间期、H- V间期、心室有效不应期以及心电图及各项参数无明显改变。对正常人 SBP无影响 ,但可降低 DBP,MBP,HR及心率、血压乘积( RPP) ,从而降低心肌耗氧量 ,而在停药后 2 0 m in内 HR,BP,RPP即基本恢复至基础状态。结论 :国产艾司洛尔主要作用于窦房结、心房与房室结 ,而对希 -浦系和心室功能无影响 ,能迅速起效且在停药时间内使临床作用基本消失 ,易根据临床状况的变化及时调整剂量 ,提示其为急症情况下一种较为安全有效的理想药物。

AIM:To investigate the electrophysiologic characteristics and clinical applications of esmolol produced in our country. METHODS:Twenty patients underwent diagnostic electrophysiologic studies before and during β blockade induced with esmolol. An initial loading dose of 500 μg·kg -1 ·min -1 was infused for 5 min and followed by a maintainance infusion of 250 μg·kg -1 ·min -1 that was continued until the completion of the electrophysiologic measurements. The measurements were initiated at 5 min after the termination of the infusion. The side effects were observed simultaneously. RESULTS:Esmolol significantly prolonged the sinus node recovery time,atrial and atrioventricular nodal effective refractory periods,the atrioventricular Wenckebach cycle length and A H interval. But it produced a significantly reduction in heart rate(HR),diastolic and mean blood pressure and rate pressure product. It did not influence the sinoatrial conduction time,P A and H V interval,ventricular effective refractory period,systolic blood pressure and electrocardiographic parameters( P >0.05). CONCLUSION:The electrophysiologic characteristics of esmolol produced in our country were similar to those reported abroad. Its major effects were on sinus node and AV node functions. Esmolol also showed no direct effects on His Purkinje or ventricular function. Esmolol decreased the HR and the myocardial oxygen demand. Esmolol,because of its ultrashort duration of action,could be safe and efficient in emergency treatments.