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关于窦房结功能障碍时使用洋地黄是否安全的问题,目前仍有争论。作者对34例作了研究,其中11例有明确的病态窦房结综合征(SSS),23例只有轻度窦率缓慢。20例于静脉注射地高辛0.75毫克前后测试窦房结功能,结果示窦性周期10例延长、8例缩短、2例不变,全组平均值改变不显著。仅3例窦率改变大于5次/分,1例大于10次/分。能测定窦房传导时间(SACT)者17例,9例延长,8例缩短,平均值改变不显著。4例SSS患者则3例延长,其中2例延长<40毫秒,另1例发生文氏型窦房阻滞,说明地高辛对SSS的SACT可有不良作用。19例测定校正的窦房结恢复时间(CSRT),全组平均值从602±551毫秒缩短至342±204毫秒,计15例缩短(其中2例缩短>300毫秒),3例不变,1例延长者仅延长87毫秒。9例长期服用地高辛,8例随访
There are still controversies about whether it is safe to use digitalis in sinus dysfunction. The authors conducted a study of 34 cases, of which 11 patients had a clear pathological sinus syndrome (SSS), 23 patients with only mild sinus rate slow. 20 cases of intravenous injection of digoxin 0.75 mg before and after the test of sinus node function, the results showed that 10 cases of sinus cycle was prolonged, 8 cases shortened, 2 cases unchanged, the whole group did not change significantly. Only 3 cases of sinus rate change greater than 5 beats / min, 1 case more than 10 beats / min. Seventeen patients were able to measure SAC, 9 were prolonged and 8 were shortened, with no significant change in mean. In 4 patients with SSS, 3 patients were prolonged, 2 of them were extended for <40 ms and the other occurred in type 1 sinoatrial block, indicating that digoxin may have adverse effects on SACT of SSS. In 19 patients, the corrected sinus node recovery time (CSRT) was measured. The mean value of the whole group was shortened from 602 ± 551 milliseconds to 342 ± 204 milliseconds, with 15 cases shortened (2 shortened> 300 milliseconds) and 3 unchanged Extensions are only extended by 87 milliseconds. Long-term use of digoxin in 9 cases, 8 cases were followed up