摘要
目的 探讨在中国人中静脉应用地尔硫治疗不稳定性心绞痛的临床疗效及有效剂量。方法 10 2例硝酸酯药物治疗效果不佳的不稳定性心绞痛患者静脉应用地尔硫 ,对心绞痛正在发作者给予首剂 10mg静脉注射 (稀释至 10ml,5min内推完 )后继续静脉滴注 ,对心绞痛未发作者直接给予持续静脉滴注 ,初始地尔硫剂量 1μg·kg-1·min-1,若仍有心绞痛发作 ,则递增剂量至 3μg·kg-1·min-1、5 μg·kg-1·min-1,心绞痛发作消失即按有效剂量维持静脉滴注 4 8h后改为口服 ;如果在 5 μg·kg-1·min-1剂量下仍不能控制心绞痛发作 ,则认为治疗无效 ,需更改治疗方案。用药过程中同时观察患者的心率、血压、心电图变化及有无低血压、心律失常、心功能不全等不良反应。结果10 2例不稳定性心绞痛患者中 ,地尔硫 1μg·kg-1·min-1有效者 6 4例 ,3μg·kg-1·min-1有效者 2 6例 ,5 μg·kg-1·min-1有效者 6例 ,累积有效率 94 12 % (96例 ) ,治疗无效者 6例 ,无效率 5 88%。治疗过程中 ,随用药时间的延长和 (或 )药物剂量的增加 ,患者的心率、血压和率压积均逐渐下降 ,与基础值相比差异有显著性 (P <0 0 5 ) ,部分患者的心电图缺血性表现得到改善。无一例在试验过程中新发生急性心肌梗死 ,除
Objective To evaluate the effect and the optimal dosage of intravenous diltiazem (Dil) on patients with unstable angina (UA) Methods 102 hospitalized UA patients who had poor responds to the nitrates were administered intravenous of Dil A loading dosage of 10mg Dil was given intravenously if the angina was attacking when the patient was admitted in hospital Otherwise with the initials dosage of 1 μg·kg -1 ·min -1 ,the dosage was added progressively from 1 μg·kg -1 ·min -1 to 3 μg·kg -1 ·min -1 and 5 μg·kg -1 ·min -1 if the angina relapsed at the former one Corresponding doses of Dil in oral formulation was prescribed if the angina kept in silence for more than 48 hours at any of those three dosages "Inefficiency" was defined as uncontrolled angina attacking at dosage of 5 μg·kg -1 ·min -1 Besides the symptom, heart rate, blood pressure, ECG and some side effects such as hypotension, arrhythmias, and heart failure were also observed during the trail Results Angina attack was controlled in 64, 26 and 6 patients at dosage of 1 μg·kg -1 ·min -1 ,3 μg·kg -1 ·min -1 and 5 μg·kg -1 ·min -1 , respectively The cumulative effective rate was 94 12% The heart rate, the blood pressure, or the rate pressure product were decreased gradually during the medication, which contributed to the angina controlling No acute myocardial infarction and no severe side effects happened during the trail except one case of reversible type II grade I AVB and one case of transient nonsymptomatic sinus arrest Conclusion Diltiazem could be prescribed as the first line drug to the unstable angina patients, especially the nitrate inefficacious ones
出处
《中华心血管病杂志》
CAS
CSCD
北大核心
2002年第10期583-586,共4页
Chinese Journal of Cardiology
