静脉应用普罗帕酮治疗254例心律失常的疗效观察

本文报道静脉应用普罗帕酮(心律平)治疗254例(295例次)心律失常患者的即时疗效。结果属显效者210例次(71.2％),有效者44例次(14.9％)及无效者41例次(13.9％),总有效率86.1％,对阵发性室上性心动过速及伴预激综合征者效果显著,对阵发性房颤及频繁房性早搏也确有较好效果,对室性心动过速效果较差。本药静脉应用奏效迅速,可作为中止快速型心律失常有效药物之一。     

心律平静脉给药对快速型心律失常的临床疗效

本文报道静脉应用心律平治疗不同病因引起的快速型心律失常30例患者的即时疗效。结果属显效者16例(53％)、有效者9例(30％)及无效者5例(17％),总有效率83％。对频繁房性早搏及室性心律失常疗效显著,对阵发性室上性心动过速及阵发性房颤也有一定效果。本药静脉应用奏效迅速,大都在5min内起效,可作为控制快速型心律失常的有效药物。     

胺碘酮治疗冠心病室性心律失常效果的临床观察

目的观察并比较胺碘酮与普罗帕酮治疗冠心病室性心律失常效果。方法随机选取90例冠心病室性心律失常患者为研究对象,按照随机化原则分为胺碘酮治疗组和普罗帕酮治疗组各45例,两组常规治疗基础疾病的措施相同,前组给予600 mg/d胺碘酮口服,3次/天,1周后剂量改为200~400 mg/d,分2次服,2周后改为每次维持200 mg或100 mg;后组给予患者150 mg盐酸普罗帕酮片口服,3次/天。4周后观察治疗效果。结果应用胺碘酮治疗45例冠心病室性心律失常患者的显效、有效、无效人数分别为21、19、5例,总有效率为88.89%,应用普罗帕酮治疗45例冠心病室性心律失常患者的显效、有效、无效人数分别为18、14、13例,总有效率为71.11%,碘胺酮的疗效和总有效率均高于普罗帕酮(P均<0.05),不良反应发生率相同(P=0.25)。结论盐酸胺碘酮治疗冠心病室性心律失常效果明显,因其有扩张冠状动脉,改善心肌供血的作用,适用于伴有器质性心脏病者,故值得临床广泛应用。     

胺碘酮在急诊快速心律失常患者急救应用

目的观察胺碘酮对快速心律失常急诊抢救的疗效及安全性。方法收集2008～2013年因在本院急诊和住院并伴发快速心律失常患者153例。首剂静注负荷量胺碘酮150mg,5～10min缓慢稀释注入,若心律失常未得到控制,可间隔15min后,再静注150mg,随后前6h以1.0mg/min维持静滴,后18h以0.5mg/min,24h总剂量600～900mg。对于伴发频发快速恶性心律失常,尤其是室速、室颤,先进行直流电除颤,胺碘酮首剂静注负荷量300mg后以1.0～1.5mg/min维持静滴维持。结果胺碘酮终止快速心律失常总有效率为90.8%,室上性快速心律失常转复率为92.5%（124/134）,室性心动过速转复率为73.6%,副作用少。结论胺碘酮是一种比较有效的广谱的抗心律失常药物。     

普罗帕酮治疗心律失常50例的即时疗效

本文报道一次口服普罗帕酮300mg治疗50例心律失常患者的即时疗效。结果显效26例(52％),有效19例(38％)及无效5例(10％),总有效率90％。对室性心律失常有效率为94％,室上性心律失常有效率为85％。起效时间3-4h。少数患者用药后有头昏、口干、暂时性血压下降副作用。1例原为房扑病例在服药后3h发生严重的室扑。本文表明普罗帕酮是一高效、速效、广谱的抗心律失常新药,但对个别病例可加重室性心律失常。     

急诊应用胺碘酮治疗冠心病快速心律失常的效果观察

目的探索盐酸胺碘酮治疗冠心病快速心律失常患者的临床治疗效果。方法将收集到的62例冠心病快速心律失常患者随机分为治疗组和对照组两组,对照组采用普罗帕酮进行治疗,治疗组采用盐酸胺碘酮进行治疗,比较两组的临床治疗疗效。结果两组患者临床疗效比较:治疗组显效18例,有效8例,无效5例;对照组显效8例,有效11例,无效12例。两组临床疗效比较组间资料采用χ2检验,P=0.0273<0.05,两组资料比较差异有统计学意义。结论采用盐酸胺碘酮治疗急诊冠心病快速心律失常的治疗效果优于使用普罗帕酮的治疗效果,且不良反应相对较少,胺碘酮是治疗此类疾病的理想的药物之一,值得在临床上推广使用。     

普罗帕酮与小剂量胺碘酮联合治疗严重快速性心律失常

静脉内以普罗帕酮为基础药物,联合小剂量胺碘酮治疗严重快速性心律失常10例,其中男7例,女3例,年龄42±s 18a。静注普罗帕酮每次70mg,3-10min注完,次间≥10min,1例静注140mg,15min后又静滴210mg。经上述处理无效,10min后静注胺碘酮每次150mg,次间≥10min。心律失常均在12min内消失,2例发生严重不良反应。     

复律汤联合治疗心律失常80例临床回顾

目的 评价复律汤与盐酸普洛帕酮片或血府逐瘀口服液联用治疗心律失常的疗效.方法与结果 自拟快速复律汤合并西药盐酸普罗帕酮治疗快速心律失常组20例,治疗3周,有效率为95%;慢速复律汤加中成药血府逐瘀口服液治疗慢速心律失常组20例,治疗4周,有效率为80%;对照1组20例快速心律失常者用盐酸普罗帕酮治疗4周,有效率为70%;对照2组快速心律失常20例用血府逐瘀口服液治疗4周,有效率为60%.结论 自拟快速复律汤合并盐酸普罗帕酮治疗快速心律失常或慢速复律汤合并血府逐瘀口服液治疗慢速心律失常疗效均明显优于单用盐酸普罗帕酮或单用血府逐瘀口服液.     

伊布利特转复房扑房颤的临床观察

目的比较新型抗心律失常药物伊布利特与普罗帕酮转复房扑/房颤的有效性及安全性。方法采用随机、单盲对照研究,选择符合条件的房扑/房颤患者共38例,按照药物编号顺序依次入组,给予富马酸伊布利特或普罗帕酮静脉泵静注,观察两组患者的房扑/房颤转复率和不良事件发生情况,同时观察血、尿指标。结果普罗帕酮组为(38±9)min的平均转复时间,转复窦性心律时为(134.5±5.8)mg的平均使用量,出现低血压2例,于动态心电图监测中另有1例患者发现窦性停搏,全天共发生4次>2.5s的窦性停搏,最长R-R间期2.8s。伊布利特组转复率78.9%(15/19),普罗帕酮组转复率31.6%(6/19)。伊布利特组转复窦性心律时有(1.6±0.5)mg的平均使用量,(28±12)min的平均转复时间,有2例患者动态心电图监测中发现短阵单型性室速。两组所有患者用药前后的化验检查无明显变化。结论伊布利特是一种快速转复房扑/房颤新型Ⅲ类的有效抗心律失常药物,具有安全、疗效迅速等优点,值值得在临床中推广使用。     

快速型心律失常应用普罗帕酮静脉给药的临床疗效分析

目的:探究分析应用静脉注射普罗帕酮对快速型心律失常的治疗效果.方法:对采用静脉注射普罗帕酮和胺碘酮的疗效进行分析对比,并探究患者的年龄、性别、病史、心律失常类型以及持续时间对疗效的影响.结果:静脉注射普罗帕酮相比胺碘酮获得了更好的疗效,可以在较短时间内使大部分患者恢复窦性心律.疗效与患者年龄、性别等无相关性,但与快速型心律失常的类型以及持续时间有关.结论:静脉注射普罗帕酮治疗快速型心律失常可以获得较好的疗效.     

普罗帕酮和胺碘酮治疗阵发性室上性心动过速疗效与安全性比较

目的 比较普罗帕酮和胺碘酮静脉用于急诊转复阵发性室上性心动过速的疗效及不良反应.方法 将急诊阵发性室上性心动过速患者86例完全随机分成普罗帕酮组(44例)和胺碘酮组(42例),普罗帕酮组给予普罗帕酮70 mg静脉注射(5 min注完),若无效,20min后重复1次;胺碘酮组给予胺碘酮5～7 mg/kg加入100 ml 5%葡萄糖或0.9%氯化钠注射液中静脉滴注,30 min滴完,继之以1 mg/min的速度持续静脉滴注.观察2组的治疗效果和不良反应发生情况.结果 普罗帕酮组和胺碘酮组转复有效率分别为93.2%(41/44)和88.1%(37/42)(P＞0.05);平均转复时间普罗帕酮组[(12.4±7.8)min]明显短于胺碘酮组[(30.7±10.3)min](P＜0.01);不良反应发生率普罗帕酮组为[29.5%(13/44)]明显高于胺碘酮组[11.9%(5/42)](P＜0.05).结论 普罗帕酮和胺碘酮用于急诊转复阵发性室上性心动过速,疗效基本相同,但普罗帕酮起效快,更适用于无器质性心脏疾患者,胺碘酮用于有器质性心脏疾患者较普罗帕酮相对安全.     

A clinical evaluation of aspoxicillin in children

Eighteen infants and children with infectious diseases were treated with aspoxicillin (ASPC), a new semisynthetic penicillin. The result was as follows: The clinical responses to ASPC were excellent in 6 patients and good in 5 patients of 11 children with bacterial infections. The bacteria isolated from the culture of throat swab and urine in 5 patients were Streptococcus pneumoniae, Escherichia coli, and Staphylococcus aureus which were all eradicated by the treatment of ASPC. The mean serum concentration of ASPC reached the peaks of 73.3 micrograms/ml in 5 cases with dose of 20 mg/kg, and 136.3 micrograms/ml in 3 cases with dose of 40 mg/kg 15 minutes after the intravenous administration. The mean half-lives of ASPC in the serum were 1.08 hours for the dose of 20 mg/kg and 1.07 hours for the dose of 40 mg/kg. The mean urinary recoveries of ASPC in 6 hours following the intravenous administration were 73.7% in 3 cases with dose of 20 mg/kg, and 79.6% in 1 case with dose of 40 mg/kg. No clinical side effect of ASPC was observed. An increase of platelet was noticed in a child with infectious mononucleosis in the course of administration of ASPC.     

Pharmacokinetic and clinical evaluation of cefpirome in the pediatric field

Pharmacokinetic and clinical evaluations of cefpirome (CPR), a newly developed cephalosporin, were performed in the field of pediatrics. The results are summarized as follows. 1. Peak serum concentrations of CPR after a dose of 20 mg/kg via 30 minutes and that via 60 minutes intravenous drip infusion and a dose of 40 mg/kg via 60 minutes intravenous drip infusion were 80.8, 63.7 and 128.8 micrograms/ml, respectively, with half-lives being 1.41, 1.28 and 1.79 hours, respectively. Urinary excretion rates for CPR in the first 6 hours after administration ranged 66.7-77.1%. 2. The clinical efficacy rate in pediatric infections obtained at daily dose levels ranging 55.6-166.7 mg/kg was 95.7%. 3. The eradication rate for 22 strains identified in the study was 95.5%. 4. Side effects were found in 2 cases of diarrhea. The abnormal laboratory test results were observed in 5 cases with 7 test items (increased number of platelets; 2 cases, increased activity of GOT; 2 cases and increased activity of GPT; 1 case). According to these results, CPR was considered to be a useful antimicrobial agent in pediatric infections.     

Pediatric montelukast ingestions reported to Texas poison control centers, 2000-2005

Limited information exists on the toxicity of pediatric ingestions of the drug montelukast used in the treatment of chronic asthma. All ingestions of montelukast involving children age 0-5 yr reported to Texas poison control centers during 2000-2005 were retrieved. For a subset of cases where the final medical outcome and dose in milligrams or milligrams per kilogram were known, the pattern of exposures by final medical outcome and management site was evaluated. There was a total of 3698 cases. Of those cases with a known final medical outcome and dose, the mean dose in milligrams was 42.5 mg (range 0.4-536 mg) and the mean dose in milligrams per kilogram was 3.36 mg/kg (range 0.18-33.71 mg/kg). The final medical outcome was no observed effect in 95% of the cases and minor effect in the remainder of the cases. The patient was managed on site in 80% of the cases. The proportion of cases with a minor effect increased from 5% for ingested dose of < or = 100 mg to 10% for > 100 mg but was 5% for dose < or = 5 mg/kg and > 5 mg/kg. The proportion of cases managed with health care facility involvement increased from 15% for ingested dose of < or = 100 mg to 56% for > 100 mg and rose from 10% for dose < or = 5 mg/kg to 47% for dose > 5 mg/kg. Pediatric montelukast ingestions of doses up to 536 mg or 33.71 mg/kg do not appear likely to result in serious adverse effects and usually can be managed at home.     

Laboratory and clinical studies on ceftizoxime in the field of pediatrics (author's transl)

Ceftizoxime, a new cephalosporin preparation, was evaluated for its antibacterial activity, absorption, excretion and clinical effectiveness, and the following results were obtained. The minimum inhibitory concentrations (MICs) of ceftizoxime against 211 clinical isolates were determined in comparison with those of cefazolin, cefmetazole, cefotiam and 6059 S. Against S. pyogenes (50 strains), ceftizoxime was 1 tube inferior to cefazolin inoculum size of 10(8) cells/ml, but was 2--3 tubes superior to cefmetazole and 6059-S. Against E. coli (50 strains), ceftizoxime and 6059-S were significantly more active than the other drugs. The susceptibility pattern of Klebsiella sp. (50 strains) to ceftizoxime was similar to that to cefotiam and 6059-S. Against Proteus sp. (50 strains), cefotiam and 6059-S were more active than the other drugs. Ceftizoxime was intermediate in activity, and cefazolin was the least active. Against H. influenzae (11 strains), ceftizoxime was the most active, with concentrations of 0.1 mcg/ml required to inhibit 100% of strains with an inoculum size of 10(8) cells/ml and 10(6) cells/ml. A dose of ceftizoxime 10 mg/kg or 20 mg/kg was administered to 15 patients aged from 5 years to 12 years, and serum levels and urinary excretion of the drug were measured. Intravenous bolus injection of the drug in dose of 10 mg/kg and 20 mg/kg yielded mean serum levels of 26.6 mcg/ml and 55.7 mcg/ml at 30 minutes, respectively. The serum levels of the drug, thereafter, declined gradually but still remained 1.3 mcg/ml and 2.7 mcg/ml at 6 hours. The serum half-lives (T 1/2) were estimated to be 1.17 hours in dose of 10 mg/kg and 1.31 hours in dose of 20 mg/kg. When a dose of 20 mg/kg was infused over a period of 30 minutes, the serum levels attained the peak of 72.4 mcg/ml to 82.4 mcg/ml (mean 79.4 mcg/ml) at the end of infusion. The levels, thereafter, tapered to mean levels of 45.3 mcg/ml at 30 minutes, 24.7 mcg/ml at 1 1/2 hours, and 3.6 mcg/ml at 5 1/2 hours, with a T 1/2 of 1.22 hours. Meanwhile, when the same dose was infused over 1 hour, the serum levels attained the peak of 59.4 mcg/ml to 68.5 mcg/ml (mean 64.2 mcg/ml). The mean serum levels after the end of infusion were 41.3 mcg/ml at 30 minutes, 21.6 mcg/ml at 1 hour and 1.9 mcg/ml at 5 hours, with a T 1/2 of 0.97 hours. Urinary recovery of the drug was 69.2% to 79.9% after intravenous injection and 62.3% to 79.9% after drip infusion, most of the given drug was excreted in the first 2 hours after administration. In our clinical study, 27 children with moderate or severe infections (12 cases of bronchopneumonia or bronchitis, 5 of pyelonephritis, 3 of purulent meningitis, etc.) were treated with ceftizoxime at the daily dose of 30--309 mg/kg for 3--23 days. Clinical response was excellent in 10, good in 9, fair in 5 and poor in 3. The drug was proved to be very effective against infections due to H. influenzae K. pneumoniae, E. coli and S. aureus. No serious side effects were observed in any case.     

胺碘酮与普罗帕酮治疗阵发性心房颤动的疗效研究

目的对比研究静脉推注胺碘酮与普罗帕酮转复阵发性心房颤动的效果。方法122例房颤持续时间<48h的患者随机分为两组,胺碘酮组62例:胺碘酮5mg/kg10min内静脉推注;普罗帕酮组60例:普罗帕酮70mg静脉推注,5～10min注完。观察30min若未转复可重复应用。结果转复率:胺碘酮组69·4%(43/62),普罗帕酮组60%(36/60),两组转复率比较差异无统计学意义(P>0·05)。结论胺碘酮和普罗帕酮对阵发性房颤均有较高的转复率。     

Laboratory and clinical studies on cefoperazone in pediatrics treatment (author's transl)

Laboratory and clinical studies of cefoperazone (CPZ), a new semisynthetic cephalosporin, were investigated and following results were obtained. (1) Blood level: CPZ was given intravenous dose of 25 mg/kg and 50 mg/kg to each 3 children. In the former, the blood level of 15 minutes after injection was 194.2 mcg/ml on average and the half life was 106.2 minutes. In the latter, the blood level was 320.0 mcg/ml on average and half life was 102.2 minutes. (2) Urinary concentration: In the cases of the dose of 25 mg/kg, 35.9% of CPZ was recovered on average from the urine within 6 hours after injection, and the urinary concentration reached to 2,148.6 mcg/ml (0 approximately 2 hours). And in the cases of the dose of 50 mcg/kg, the recovery rate in urine was 43.6%, and the urinary concentration was 3,008.3 mcg/ml. (3) Cerebrospinal fluid level: CSF level was determined in a patient with bacterial meningitis by S. pneumoniae. Ninety mg/kg of CPZ were given intravenous injection. After 60 minutes CSF level was 3.35 mcg/ml, and after 80 minutes the blood level was 192.0 mcg/ml. (4) Bacteriological evaluation: Against 164 strains isolated clinical specimens, the bacteriological evaluation on CPZ was performed in comparison with cefotaxime (CTX), cefazolin (CEZ) and piperacillin (PIPC) by inoculum size of 10(8) cells/ml. CPZ showed antibacterial activity against Gram-negative bacteria almost similar to CTX and PIPC. (5) Clinical results: CPZ was given 48.3 approximately 360 mg/kg/day (average 146.1 mg/kg/day) by intravenous route to 46 patients with various infection. The overall efficacy rate was 80.4%. The rate of bacteriological effectiveness was 78.9% in 19 cases. (6) Side effects: As side effects, diarrhea, fever, rash, urticaria, leukopenia, eosinophilia, elevation of GOT, GPT, and LDH were observed, but not seriously.     

普罗帕酮治疗窄QRS波室上性心动过速疗效分析

目的探讨普罗帕酮终止窄QRS波室上性心动过速的最佳给药方法。方法按完全随机法将符合入选标准的36例窄QRS波室上性心动过速患者分为观察组和对照组各18例。观察组给药剂量为1mg／kg,静脉2min推注完毕,并立即静脉推注5％葡萄糖10ml;对照组按1mg／kg取药,加5％葡萄糖10ml稀释后静脉推注,5min推注完毕。观察2组转复率、转复时间、不良反应发生率。结果给药速度越快,转复为窦性心律越快,不良反应发生率越低。观察组和对照组患者转复成功率分别为88．9％和77．8％,转复时间分别为（2．5±1．6）min和（4．1±2．3）min,2组转复成功率、转复时间差异无统计学意义（P〉0．05）。结论以1mg／kg普罗帕酮2min推注完毕能快速终止窄QRS波室上性心动过速的发生且不良反应发生率较低。     

Pharmacokinetics and clinical efficacy of flomoxef in neonates]

Clinical pharmacology and efficacy of flomoxef (FMOX) in neonates were investigated. And the following results were obtained. 1. Mean serum concentrations of FMOX at 30 minutes after administration were 24.3 micrograms/ml, 47.6 micrograms/ml, and 85.8 micrograms/ml at doses of 10 mg/kg, 20 mg/kg, and 40 mg/kg administered, respectively. 2. Mean serum half-lives of FMOX were 3.4 hours in 0-3 day-old neonates, and 2.6 hours in 4 day-old or older subjects. 3. A dose response was evident among different dose groups given 10 mg/kg, 20 mg/kg, and 40 mg/kg. 4. Urinary recovery rates of FMOX in the first 6 hours after administration ranged between 12.8 and 51.1%. 5. FMOX was effective in 7 out of 8 cases in which causative pathogens were identified. 6. Diarrhea was observed in 1 case as a side effect of the drug, but the symptom was relieved soon after the completion of the treatment. There was no case in which any abnormal laboratory results were observed. 7. FMOX has a broad spectrum of activities against Gram-positive and Gram-negative aerobes and anaerobes. It is stable against most of beta-lactamases. It was demonstrated to be highly effective in our study, and yet without any serious side effects. FMOX is therefore considered to be one of the useful agents of the first choice for the treatment of bacterial infections such as sepsis and urinary tract infections in neonates and infants.