地尔硫注射液治疗老年心力衰竭伴快速房性心律失常的疗效和安全性研究

目的观察老年中度和重度心力衰竭伴快速房性心律失常(包括心房颤动和心房扑动)患者静脉注射地尔硫控制心室率的有效性和安全性。方法选取NYHAⅢ、Ⅳ级的中、重度心力衰竭伴快速房性心律失常的老年患者,给予地尔硫静脉注射,观察有效率及血压、症状和体征变化。结果85例患者入选,80例(94.1%)患者有效,心室率由用药前的(149.5±18.2)次/分下降至用药结束时的(95.3±17.5)次/分,下降幅度36.2%,平均起效时间(6.3±3.9)分钟,用药前后心室率下降有显著意义(P<0.001)。所有患者血压均有下降但多在正常范围,有5例出现低血压,1例出现Ⅰ度房室传导阻滞伴窦性心动过缓,无1例出现心功能恶化。结论静脉注射地尔硫能迅速有效地控制中重度心力衰竭伴快速房性心律失常的老年患者的快速心室率,而且安全性高。

Efficacy and Safety of Intravenous Diltiazem on Rapid Atrial Arrhythmias Accopanied by Congestive Heart Failure in Elderly

Objective To evaluate the efficacy and safety of intravenous diltiazem for treatment of rapid artrial arrhythmias accompanied by congestive heart failure(CHF) in elderly patients.Methods Ventricular rate,ECG,BP and clinical symptom were observed in 85 elderly patients(≥65 Y) with rapid atrial fibrillation or atrial flutter accompanied by CHF (NYHA Ⅲ and Ⅳ) after intravenous diltiazem.Results The total efficacy was 94.1% with a mean decrease in ventricular rate by 36.2% of the baseline.The ventricular rate decreased from 149.5±18.2 bpm to 95.3±17.5 bpm 20 min after injection(P<0.001).And mean time response to the bolus was 6.3±3.9 minutes.Of the 85 patients treated with diltiazem,5 cases developed hypotension and only one developed Ⅰ~0-AVB and bradycardia.No patient developed worsening of CHF.Conclusions Diltiazem is effective and safety in treating rapid atrial arrhythmias accompanied by congestive heart failure in elderly patients.