钟毅,殷永强,谭立,史静,赵洋
ZHONG Yi,YIN Yongqiang,TAN Li,SHI Jing,ZHAO Yang

• 1:贵州医科大学附院麻醉科

摘要(Abstract)：

目的:观察右美托咪定对健康自愿校正QT间期(QTc)和QT间期离散度(QTd)的影响。方法:健康自愿者20名,18~30岁,体重指数19~26 kg/m~2,先后给予受试者两个剂量的Dex,静脉注射右美托咪定负荷量1.0μg/kg泵注10 min,随后持续泵注0.5μg/(kg·h)50 min(Ⅰ剂量组);1~2周后静脉注射右美托咪定负荷量1.5μg/kg泵注10 min,随后持续泵注0.75μg/(kg·h)50 min(Ⅱ剂量组);于Dex静脉泵注前(T_0)、Dex静脉泵注后25 min(T_1)、Dex静脉泵注后45 min(T_2)监测给药过程中心率(HR)、PR间期、QRS波时间、QT间期、QTc及QTd。结果:T_1、T_2时的HR较T_0时显著降低(P<0.05),T_1、T_2时的PR间期、QRS波时间、QT间期较T_0时显著延长(P<0.05),T_1、T_2时的QTc较T0时无显著变化(P>0.05),以上指标两剂量组间比较差异无统计学意义(P>0.05);Ⅰ剂量组的T_1时和Ⅱ剂量组T_1、T_2时的QTd较T_0时显著延长(P<0.05),T_2时Ⅱ剂量组QTd较Ⅰ剂量显著延长(P<0.05)。结论:右美托咪定使QTd增加,随药物剂量的增加QTd有增加的趋势,但QTc无显著延长。
Objective: To investigate the effect of dexmedetomidine(Dex) on corrected QT interval(QTc) and QT interval dispersion(QTd) in healthy volunteers. Methods: 20 healthy volunteers,aged 18 ~ 30 years old with a body mass index of 19 to 26 kg/m~2 were included in the clinical trials.Subjects entered into DoseⅠ firstly,and then entered Dose Ⅱ. They received intravenous injection of Dex at loading dose of 1 μg/kg for 10 min and then at 0.5 μg/(kg·h) for 50 min(DoseⅠ). 1 ~ 2weeks later,they again received intravenous injection of Dex at loading dose of 1. 5 μg/kg for 10 min and then at 0. 75 μg/( kg·h) for 50 min(DoseⅡ). HR,PR interval,width of QRS,QT interval,QTc and QTd were recorded before pump injection Dex(T_0),after pump injection Dex 25min(T_1),and after pump injection Dex 45 min(T_2). Results: Compared with T0,HR were significantly decreased at T_1,T_2(P<0. 05) while PR interval,width of QRS,QT interval significantly prolonged at T_1,T_2(P<0. 05),but QTc was not significantly changed(P>0.05). There were no statistically significant differences in all above indexes between Dose I group and Dose II group(P>0.05). Compared with at T_0,QTd were significantly prolonged at T_1 in Dose Ⅰ and at T_1,T_2 in Dose Ⅱ. QTd of DoseⅡ were significantly prolonged at T_2 than that of Dose I(P<0.05). Conclusion: Dexmedetomidine can increase QTd,and QTd increases with the dosage. But QTc cannot be significantly prolonged.

关键词(KeyWords)： 麻醉药;肾上腺素能激动剂;右美托咪定;校正QT间期;QT间期离散度
anesthetics;adrenergic agonists;dexmedetomidine;corrected QT interval;QT Interval dispersion

Abstract:

Keywords:

基金项目(Foundation): 贵阳市科技计划项目[筑科合同(20161001号]

作者(Author): 钟毅,殷永强,谭立,史静,赵洋
ZHONG Yi,YIN Yongqiang,TAN Li,SHI Jing,ZHAO Yang

DOI: 10.19367/j.cnki.1000-2707.2017.01.020

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