ABSTRACT
Objective To evaluate the clinical application value of transesophageal atrial pacing (TEAP) combined with atropine load experiment in the diagnosis of the lesions of sinoatrial node and atrioventricular node.Methods One hundred and forty-four cases selected from the outpatient and hospitalized patients in the People's Hospital of Changji Hui Autonomous Prefecture from September 2009 to December 2012,who with dizziness, syncope and other clinical symptoms and electrocardiogram showe.TEAP combined with atropine load experiment were given to these patients.Results (1) The authors detected in all patients,83 cases (57.6％) were positive, among which, 48 cases (57.8％) male, 35 cases (42.2％) female.(2) The authors detected 57 cases(39.6％) non-increased vagus nerve tension cases in 83 positive cases,among which 33 cases (57.9％) male, 24 cases (42.1％) female;Among which 29 cases (20.1％) were sinoatrial node hypofunction, and 16 cases(55.2％) male;8 cases(5.6％) were atrioventricular node hypofunction,and 4 cases(50％) male;14 cases(9.7％) were double node hypofunction, and 10 cases (71.4％) male;6 cases (4.2％) were tachycardia-bradycardia syndrome, and 3 cases (50％) male;among which, a long interval of greater than 3 seconds appeared when we stimulate one 84 years old man with S1S1 stimulate way, immediately pressed protective pacemaker until his own sinus rhythm was restored, as a safety precaution, stoped further examination and classified him as sick sinus group.Conclusion Detect the common causes of slow sinus and atrioventricular block,such as the sinoatrial node dysfunction, atrioventricular node dysfunction, double node dysfunction and increased vagus nerve tension through TEAP combined with atropine load experiment.Consider that this methods have the best diagnostic value in decreasing its rate of false positivity,and should be used as a necessary check before implantation of pacemaker in such patients, suitable used in clinical, especially in basic general hospitals.
ABSTRACT
Objective To observe the effect of lowering intraocular pressure(IOP) treatment on ocular hemodynamics in patients with nonarteritic anterior ischemic optic neuropathy (NAION).Methods A total of 68 patients with NAION (68 eyes) were enrolled in this study.The patients were randomly divided into treatment group (38 eyes of 38 patients) and control group (30 eyes of 30 patients).All the patients were received methylprednisolone pulse therapy (200 mg,three days),vasodilator therapy with intravenous infusion of Xueshuantong solution (300 mg),optic nerve nutritional therapy with mouse nerve growth factor (30 μg) and acupoint injection in temporal with compound anisodine (2 ml).The total course was 10 days.The patients of treatment group received IOP lowering treatment to reduce the IOP to ≥ 8 mm Hg (1 mm Hg=0.133 kPa) or in a 30％ reduction.The patients of control group received no IOP lowering treatment.The peak systolic velocity (PSV),pulsatility index (PI) and resistance index (RI) of ophthalmic artery (OA),central retinal artery (CRA) and short posterior ciliary arteries (PCA) before and after treatment were comparatively analyzed by color doppler flow imaging.Results The differences of PSV (t=1.023,1.145,0.569),PI (t=0.679,0.956,1.634) and RI (t=0.816,1.657,0.998) of OA,CRA and PCA before treatment in treatment group and control group were not statistically significant (P＞ 0.05).Compared with before treatment,PSV (t=3.150,7.650,3.520) and PI (t=2.420,5.430,7.650) of OA,CRA and PCA increased obviously (P＜0.05),RI of OA,CRA and PCA decreased obviously (t=5.320,9.640,18.360; P＜0.05) after treatment in treatment group.In control group,the differences of PSV (t=2.090,-2.550,-2.100) and PI (t=-2.310,-2.230,-4.490) of OA,CRA and PCA between before and after treatment were not statistically significant (P＞0.05) ; but the differences of RI of OA,CRA and PCA between before and after treatment was statistically significant (t=2.970,2.160,2.690μ P＜0.05).Compared with control group,PSV (t=2.632,2.135,5.364) and PI (t=3.251,2.432,4.243) of OA,CRA and PCA increased obviously (P＜0.05),RI of OA,CRA and PCA decreased obviously (t=3.664,2.938,4.324; P＜0.05) after treatment in treatment group.Conclusion Lowering intraocular pressure treatment can improve the ocular hemodynamics in NAION patients.