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目的:观察抗胆碱药盐酸戊乙奎醚(penehyclidine hydrochloride,PH)对健康受试者心率及心率变异性的作用,初步探讨其对自主神经活动的影响。方法:健康受试者26例,男女各半,年龄20~30岁,随机分为0.3,0.4,0.6,0.8和1.0 mg PH组,单次给药。每个剂量组随机选择2例(男女各1例)受试者行24 h动态心电图监测,采集健康受试者给药前后24 h的平均心率及心率变异性时域参数(SDNN,SDNN Idx,r MSSD,SDANN,p NN50,TI);其余16例受试者采用常规心电图监测记录给药前后24 h心率。比较给药前后24 h心率,并采用心率变异性(heart rate variability,HRV)时域分析法考察心率变异性的变化。结果:PH给药后,常规心电图显示受试者心率明显减慢(P<0.05);动态心电图监测结果表明受试者24 h平均心率与给药前相比显著减慢(P<0.01),1 h SDNN显著提升(P<0.01),24 h长程SDNN,SDNN Idx,r MSSD,p NN50和TI水平较给药前呈上升趋势;SDANN水平略低于给药前。结论:PH可能通过非M2受体或增强迷走神经张力影响HRV,进而减慢心率。
OBJECTIVE: To observe the effect of penehyclidine hydrochloride (PH) on heart rate and heart rate variability in healthy subjects, and to explore its effect on autonomic nervous activity. Methods: Twenty-six healthy subjects, half male and half female aged 20-30 years, were randomly divided into three groups: 0.3, 0.4, 0.6, 0.8 and 1.0 mg PH group. In each dose group, 2 subjects (1 male and 1 female) were randomly selected and monitored by 24-hour Holter monitoring. The average heart rate and heart rate variability time domain parameters (SDNN, SDNN Idx, r MSSD, SDANN, p NN50, TI). The remaining 16 subjects recorded the heart rate 24 h before and after the administration by conventional ECG monitoring. The 24 h heart rate was compared before and after administration, and heart rate variability (HRV) time-domain analysis was used to investigate the changes of heart rate variability. Results: After the administration of PH, the heart rate of the subjects decreased significantly (P <0.05). The results of Holter monitoring showed that the 24-hour average heart rate of the subjects decreased significantly (P <0.01) (P <0.01). The levels of SDNN, SDNN Idx, r MSSD, p NN50 and TI in 24 h increased significantly compared with that before administration, while SDANN was slightly lower than that before administration. CONCLUSION: PH may affect HRV through non-M2 receptors or increase vagal tone, thus slowing heart rate.