摘要
OBJECTIVE: To investigate whether transdermal scopolamine increased cardiac vagal activity in patients during the acute phase of myocardial infarction. METHODS: 30 patients with a first acute myocardial infarction and preserved sinus rhythm who were on no drug that could influence the sinus node were randomly assigned to either treatment group or placebo group. Measures of heart rate variability (HRV) in patients given drug or placebo were obtained by digital 24 hour Holter recording before and after treatment. Baroreflex sensitivity was performed using the phenylephrine method. RESULTS: No significant differences was found in the indices of the time domain and the frequency domain in both groups before treatment. Patients with transdermal scopolamine showed a significant increase in the standard deviation of normal RR intervals (SDNN), standard deviation of all five min mean normal RR intervals (SDANN), root mean square of differences of successive normal RR intervals (rMSSD), total power (TP, 0.000. - 0.40 Hz), low frequency peak (LF, 0.040 - 0.15 Hz), high frequency peak (HF, 0.15 - 0.40 Hz), and Baroreflex sensitivity after treatment (P
目的 研究心肌梗死急性期经皮给予小剂量东莨菪碱能否增加心脏迷走神经的张力。方法 30例首次急性心肌梗死 (AMI)患者 ,窦性心律 ,未用任何影响窦房结的药物 ,随机分为东莨菪碱组和安慰剂组 ,双盲法给药。治疗前后用数字化 2 4小时Holter记录测定心率变异性时域参数。用苯肾上腺素法测定压力反射敏感性。结果 治疗前心率变异性参数和压力反射敏感性在两组间无明显差异。经皮东莨菪碱治疗明显增加心率变异的时域参数 [RR间期标准差均值 (SDNN) ,RR间期均值标准差 (SDANN)和相邻RR间期差值的均方根 (rMSSD) ]和频域参数 [总功率谱 (TP ,0 - 0 4 0Hz)、低频 (LF ,0 4 0 - 0 15Hz)和高频 (HF ,0 15 - 0 4 0Hz) ]及压力反射敏感性。结论 心肌梗死急性期应用小剂量东莨菪碱透皮治疗可显著增加心脏迷走神经张力 ,改善自主神经失衡。
