摘要
本文对20例卧位型心绞痛患者的临床及血液动力学资料进行分析,提出左心功能不全不是该型心绞痛的主要诱发因素,而严重冠脉阻塞性病变基础上左室舒张功能异常是诱发其发作的主要原因。并指出在无左心功能不全情况下,β受体阻滞剂加扩冠药物可作为卧位型心绞痛的首选药物。
In order to investigate the mechanism of angina decubitus, twenty patients, 18 men and two women (36-70 years of age), were studied during hospitalization. Continuous hemodynamic monitoring was done in 11 patients using Swan-Ganz catheter. Our findings demonstrated that all patients had increase of rate-pressure product before the onset of angina decubitus indicating that this kind of angina belongs to the category of effort angina. Of the eleven patients having hemodynamic data, three (cases No. 1-3)had significant progressive increase of PASP and PADP before the onset of angina decubitus, and their episodes of angina could not be completely controlled by digoxin and diuretics, but quickly subsided by the combined use of digoxin and beta blockers. Among the other eight patients, PADP increased slightly in five and remained unchanged n the rest before the episodes of angina decubitus; these patients had no manifestation of LV dysfunction, and beta blockers combined with coronary vasodilators produced satisfactory therapeutic effect. These results indicate that LV failure is not a major factor in the pathogenesis of angina decubitus. The episodes of angina decubitus were preceded by increase of PADP in eight of the eleven patients, suggesting that these patients had an abnormal LV diastolic function possibly related to LV hypertrophy paused by long-term hypertension or chronic persistent ischemia. Our results suggest that beta blocker is the drug of choice for patients with angina decubitus. A combination of digoxin with beta blockers might be used for those with LV failure.
出处
《中国循环杂志》
CSCD
1992年第3期228-231,共4页
Chinese Circulation Journal
关键词
卧位型
心绞痛
左室舒张功能
Angina decubitus
LV diastolic dysfunction
Beta blockers
