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Objective To observe the effects of Wenxinkeli combination use with buspirone on the treatment of cardiac neurosis with ST-T changes.Methods Ninety patients with cardiac neuropathy were randomly divided into placebo group, Wenxin Granule group and combination use group (Wenxinkeli combination use with buspirone),30 cases in each group.The scores of HAMA-14 and HAMD-24 of the three groups were observed at the end of 4 and 8 weeks after treatment when the score of SF-36 and the improvement of ST-T of combination use group were evaluated followed 12 weeks treatment.Results After 4 weeks of treatment, the two scale scores of combination use group and the Wenxinkeli group, including HAMD-24 and HAMA-14, were significantly lower than the placebo group (P<0.05).In comparison with placebo group, the scores of HAMD-24 and the HAMA-14 were significantly lower after 8 weeks treatment.After 12 months of follow-up treatment, the SF-36 scores of combination use group were significantly higher than the other two groups'(P<0.05).Meanwhile, our results showed that the ST-T changes of the combination use group was significantly improved than the other two groups'(P<0.05).Conclusion The treatment of Wenxinkeli combination use with buspirone can significantly decrease anxiety and improve depression in patients with cardiac neurosis, moreover, long-term combination use treatment can distinctly improve patients' quality of life and relieve their physical symptoms of ST-T changes.
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BACKGROUND: ST changes that do not fulfill the criteria of specific one-ST changes greater or equal to 1 mm and lasting over 1 minute-, are termed as "nonspecific". The term, "nonspecific ST-T change", has not had an important role as a guildeline of treatment. However, the incidence of "nonspecific ST-T changes" is estimated as not so negligible, and the relation to postoperative complications or the role as a coronary prognostic risk value has not been studied so far, so the authors thought to examine the general characteristics and course during the perioperative period of "nonspecific ST-T change" patients to conduct better anesthesia services. METHODS: From January 1st to June 30th in the year 2000, medical charts of patients who underwent an operation in one university hospital under general or regional anesthesia and whose preoperative electrocardiographic finding was "nonspecific ST-T changes" were reviewed. In the preoperative viewing of charts, demographic data, co-existing disease, findings in electrocardiography or echcardiography, and replies of a consultation to a cardiologist were reviewed. In the anesthesia records, nature of conducted anesthesia, agents, operation time and drugs acting on the cardiovascular system were reviewed. RESULTS: Incidence of "nonspecific ST-T changes" patients is 8.24%. Mean age is 54 +/- 16 yrs and the ratio of M : F is about 1 : 2. The number of patients who had other medical diseases was 42, about 27%. The number of patients who underwent a preoperative echocardiography was 64, about 42%. Mean ejection fraction was 65 +/- 7%. The number of patients who consulted a cardiologist preoperatively was 44, about 22% and the majority of them were OK'd as "no problem". Administration of drugs acting on the cardiovascular system was done in 49 cases, about 33%. General anesthesia was conducted in 131 cases, regional anesthesia in 23 cases. CONCLUSIONS: In all cases, operations were performed without specific events or major complications. However more attention and risk evaluation is desirable in "nonspecific ST-T change" patients to conduct safer and more ideal anesthesia.
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Humanos , Anestesia , Anestesia por Condução , Anestesia Geral , Sistema Cardiovascular , Ecocardiografia , Eletrocardiografia , Incidência , Período Perioperatório , Complicações Pós-OperatóriasRESUMO
OBJECTIVES: Accurate differential diagnosis of paroxysmal supraventricular tachycardia (PSVT) has become more important after introduction of curative catheter ablation technique into clinical practice. It has been reported that ST-T changes during supraventricular tachycardia are frequent, but its association is different according to the type of PSVT and the location of the AV bypass tracts. Therefore, this study was performed to evaluate the significance of ST-T changes in addition to classic ECG parameters in differentiating AV nodal reentrant tachycardia (AVNRT) and AV reentrant tachycardia (AVRT), and predicting the location of the AV bypass tracts. METHODS: One hundred thirty patients presenting with narrow-QRS complex ( or =1 mm was observed in 27.8% of AVNRT and 79.9% of AVRT (p or =2 mm was observed in 76.9% of the left posterior pathways, 28.1% of the left anterolateral pathways, 66.7% of the right posterior pathways, and 1.1% of the right anterior pathways. Sensitivity, specificity, and positive predictive value in differentiating AVRT from AVNRT with visible p wave were 72%, 91%, and 92%, respectively : 78%, 72%, and 80%, respectively with ST segment depression > or =1 mm, and 30%, 93%, and 85%, respectively with T wave inversion. In differentiating AVNRT from AVRT, Sensitivity, Specificity, and positive predictive value of pseudo r' wave and pseudo s wave were 59%, 92%, 84%, respectively and 33%, 99%, 94%, respectively. Sensitivity, specificity, and positive predictive value in distinguishing posterior location from anterior location of the pathways were 74%, 76%, and 72%, respectively with ST segment depression (> or =2 mm) and 46%, 83%, and 70%, respectively with T wave inversion. CONCULSIONS: ST Segment depression during PSVT can be used complementally to the classic ECG parameters in the differential diagnosis of PSVT and predicting the location of the AV bypass tracts.