摘要
目的探讨慢性阻塞性肺疾病(COPD)患者使用氨茶碱治疗过程中出现心律失常的因素。方法回顾性分析55例COPD的临床资料,对比分析不同氨茶碱血药浓度、不同病程、不同年龄、有无心脏合并症等情况下心律失常的发生率。同时总结氨茶碱致心律失常的类型及发病机理。结果不同氨茶碱血药浓度、不同病程、不同年龄、有无心脏合并症的患者心律失常的发生率间差异均有显著性意义(P<0.01)。心律失常主要表现为窦性心动过速、房性心动过速、房早、室早、房颤、房扑,均为快速性心律失常。结论COPD患者使用氨茶碱时,如合并肺心病、冠心病、氨茶碱血药浓度>20mg/L、年龄≥65岁、病程≥15年,易发生心律失常或使原有的心律失常加重。此类患者使用氨茶碱剂量不宜过大,应定期查心电图,一旦出现新的心律失常或原有的心律失常加重,应考虑氨茶碱中毒的可能,及时停用氨茶碱,并监测其血药浓度。
Objective To explore the influencing factors of cardiac arrhythmia during chronic obstructive pulmonary disease （COPD） patients treated with aminophylline. Methods Clinical data of 55 cases of COPD were analyzed by retrospective methods. The occurring rates of cardiac arrhythmia were contrasted in different circumstances, such as different blood concentration of aminophylline,different courses of disease, different ages, company with or without cardiac eomplieations. The types and pathogenesis of cardiac arrhythmia caused by aminophylline were summed up at the same time. Results The occurring rate differences of cardiac arrhythmia existed in different patients with different blood concentration of aminophylline,in the different courses of disease, at different ages, company with or with- out cardiac complications, and these differences had great signifieances （P 〈 0.01 ）. The manifestations of cardiac arrhythmia included sinus tachyeardia, atrial taehyeardia, atrial premature baets, ventrieular premature beats, atrial fibrillation, atrialflutter, all for taehyarrhythmias. Conclusion COPD patients easily experienced cardiac arrhythmia or aggravation of original cardiac arrhythmia when they were treated with aminophylline if they complicated chronic pulmonary heart disease, or coronary atherosclerotic heart disease, or blood concentration 〉 20 mg/L, or ages≥65 years old, or courses of disease ≥ 15 years. So the dose of aminophylline should be decreased on these patients and have regular electrocardiogram examinations on them. Once new cardiac arrhythmia occurs or the original cardiac arrhythmia become worse, the possibility of aminophylline intoxeation should be considered. At that time, we should stop using aminophylline immediately and monitor the blood concentration.
出处
《临床肺科杂志》
2008年第12期1562-1563,共2页
Journal of Clinical Pulmonary Medicine
关键词
氨茶碱
心律失常
血药浓度
慢性阻塞性肺病
中毒
aminophylline
cardiac arrhythmia
blood concentration
chronic obstructive pulmonary disease
intoxcation
