老年冠心病心律失常运用盐酸胺碘酮片治疗的临床研究

目的:探究老年冠心病心律失常运用盐酸胺碘酮片治疗的临床效果.方法:将我院2013年1月～2017年1月收入的老年冠心病心律失常患者88例根据方法不同分为普罗帕酮组、胺碘酮组各44例.普罗帕酮组采用普罗帕酮进行治疗;胺碘酮组运用盐酸胺碘酮片治疗.比较两组冠心病心律失常治疗总有效率;房性早搏、室性早搏和交界性早搏次数;不良反应发生率;治疗前后心率和QTd.结果:胺碘酮组冠心病心律失常治疗总有效率比普罗帕酮组高(P<0.05);胺碘酮组房性早搏、室性早搏和交界性早搏次数比普罗帕酮组少,P<0.05;两组不良反应发生率无显著差异,P>0.05.治疗前两组心率和QTd无显著差异,P>0.05.治疗后胺碘酮组心率和QTd优于普罗帕酮组,P<0.05.结论:老年冠心病心律失常运用盐酸胺碘酮片治疗的临床效果确切,可改善临床症状和心功能,值得推广.     

普罗帕酮联合稳心颗粒对女性心律失常患者的临床观察

目的探讨普罗帕酮联合稳心颗粒治疗女性心律失常的临床疗效。方法将168例女性心律失常患者随机分为治疗组服用普罗帕酮150 mg、1次/8小时,稳心颗粒9 g、3次/天、冲服。对照组服用美托洛尔12.5²5.0 mg,2次/天,治疗4周,同时服用谷维素、维生素B1,对动态心电图及临床症状进行观察。结果两组患者的临床症状明显缓解,快速性心律失常发生次数明显减少。普罗帕酮联合稳心颗粒对女性心律失常疗效较好,对房性早搏伴短阵房性心动过速或短阵房扑、房颤(室上性心律失常)总有效率86.96%,频发室性早搏、室早二联律(室性心律失常)总有效率89.98%,临床症状缓解率91.86%。而美托洛尔分别为73.81%,82.50%,79.27%,2组比较有统计学意义。结论普罗帕酮联合稳心颗粒更能明显改善女性心律失常的临床症状,尤其对房性早搏和室性早搏疗效确切,不良反应少而轻,患者有较好的耐受性。     

步长稳心颗粒治疗心律失常临床疗效观察

目的观察步长稳心颗粒治疗心律失常的临床疗效及不良反应。方法118例心律失常室性早搏、房性早搏患者,随机分为两组,治疗组给予稳心颗粒口服;对照组给予普罗帕酮口服。比较观察治疗心律失常的临床疗效及药物不良反应。结果稳心颗粒治疗室性早搏、房性早搏心律失常的总有效率为86．44％（51／59）,不良反应轻微且发生率低8．47％（5／59）;普罗帕酮治疗室性早搏、房性早搏心律失常的总有效率为76．27％（45／59）,不良反应发生率为11．56％（7／59）。结论步长稳心颗粒治疗室性早搏、房性早搏心律失常疗效好,不良反应轻微,值得临床推广应用。     

胺碘酮治疗无症状心肌缺血伴室性早搏的临床疗效

目的 :观察胺碘酮治疗冠心病无症状心肌缺血 (SMI)伴室性早搏 (VPB)的疗效和安全性。方法 :将 92例患者分成胺碘酮组、硝酸异山梨酯组和普罗帕酮组。疗程 38d ,用DCG观察SMI和VPB改善情况。结果 :与治疗前比较 ,胺碘酮组SMI发作次数明显降低 [(2 3± 1 0 )vs (7 7± 4 3) ,P <0 0 1],持续时间明显缩短 [(3 7± 1 8)minvs (19 4± 12 4 )min ,P <0 0 1],胺碘酮组疗效较硝酸异山梨酯组显著提高 (P <0 0 5 ) ;胺碘酮组治疗VPB有效率 90 6 %,较普罗帕酮疗效好 (P <0 0 5 )。未见严重不良反应。结论 :胺碘酮治疗SMI伴VPB有确切疗效和安全性。     

探讨普罗帕酮联合美托洛尔对小儿心律失常的临床疗效

目的观察探讨普罗帕酮联合美托洛尔对小儿心律失常的临床疗效,总结其用药经验和临床应用价值。方法选取我院2010年3月至2012年3月发生心律失常的患儿48例,按照数字表随机抽取的方法将其分为观察组与对照组,各有24例,观察组使用普罗帕酮联合美托洛尔治疗,对照组单纯使用普罗帕酮治疗,观察对比两组的临床疗效。结果观察组治疗后疗效总有效率为91.7%(22/24),不良反应发生率为8.3%;对照组经治疗后疗效总有效率为66.7%(16/24),不良反应发生率为8.3%,两组治疗4周后的疗效比较存在明显的差异(P<0.05),具有统计学意义;两组治疗中的药物不良反应发生率比较无显著性的差异(P>0.05),无统计学意义。观察组治疗后短阵室速、短阵房速、室性早搏、房性早搏的发作次数显著对比对照组减少(P<0.05),具有统计学意义。结论普罗帕酮联合美托洛尔对小儿心律失常的临床疗效的临床疗效显著,明显对比单纯使用普罗帕酮治疗,可以有效缓解患儿的临床症状,减少各种类型心律失常的发作,且不良反应小,安全可靠,值得临床推广并且合理使用。     

普罗帕酮联合美托洛尔对小儿心律失常的临床研究

目的:探讨普罗帕酮联合美托洛尔对小儿心律失常的临床疗效。方法:选取2016年3月~2017年4月我院收治的60例小儿心律失常患者,以随机数表法分成观察组与对照组各30例。对照组患儿口服普罗帕酮治疗,观察组患儿口服普罗帕酮和美托洛尔治疗。对比两组患儿治疗后房性早搏、室性早搏、矩阵房速及矩阵室速发作的次数和临床疗效。结果:观察组治疗后房性早搏、室性早搏、矩阵房速及矩阵室速均明显低于对照组,P0.05;观察组治疗后总有效率明显低于对照组,P0.05;两组治疗后不良反应率对比无差异,P0.05。结论:普罗帕酮联合美托洛尔对小儿心律失常的临床疗效显著,值得临床推广。     

普罗帕酮治疗小儿室性早搏50例

普罗帕酮对急性发作的心律失常效果较好,特别对小儿室性早搏疗效尤其明显.并且对房性早搏也有一定的疗效.故用于各种异位心律的治疗.我们用普罗帕酮治疗小儿病理性室性早搏50例,取得了较满意的效果.1 资料与方法1.1 病例选择 从1991年2月～1995年2月,选择本院门诊和住院的心律失常患儿50例,其中男32例.女18例.年龄3～12y,平均7.5y.病程<6mo30例,6mo20例,经Holter检查,室性早搏为多源性,成对或短阵出现.并且心率加快.早搏频繁,平均定性早搏次数≥10beats/min15例,<7～10beats/min35例.排除病例:Holter显示室性早搏为     

CYP2D6*10基因型对中国室性心律失常病人普罗帕酮药效学的影响(英文)

目的:观察CYP2D6＊10基因型对普罗帕酮在室性心律失常病人中药效学的影响.方法:选择17名室性早搏(VPC≥1000/d)病人.受试者常规实验室检查结果正常,每日3次、每次口服普罗帕酮片剂150-200 mg.于给药前与给药后7 d测定病人心电图和24 h动态心电图(Holter).普罗帕酮稳态峰、谷浓度采用高效液相色谱分析法测定.采用聚合酶链反应(PCR)和限制性片断长度多态性(RFLP)测定CYP2D6＊10基因型.结果:17例室性心律失常病人应用普罗帕酮后,室性早搏总抑制率为79.9％,PR间期延长从0.146 s±0.018 s增加到0.161 s±0.022 s(P<0.05).CYP2D6基因型在普罗帕酮血浆浓度和效应中起着重要作用.450 mg/d剂量组中具有CYP2D6*10 突变纯合子的病人,普罗帕酮血浆峰浓度约为野生基因型的二倍,而且VPC抑制率也增加一倍(P<0.05).结论:CYP2D6＊10基因型与中国心律失常病人CYP2D6酶活性下降有关.普罗帕酮血浆峰浓度增加与室性早搏病人疗效改善相一致.     

牛磺酸、普罗帕酮合用抗实验性心律失常作用及对心肌收缩力的影响

目的　研究牛磺酸、普罗帕酮及二者合用对实验性心律失常的对抗作用及对麻醉大鼠心肌收缩力的影响。方法　采用氯化钡或乌头碱诱发大鼠心律失常 ,以室性双向性心律失常持续时间和发生率及引起室早、室速、室颤的乌头碱剂量为指标 ,观察牛磺酸、普罗帕酮单用及合用对二种模型的影响 ;观察单用及合用对麻醉大鼠心率 (HR)、左室收缩压(LVSP)、左室内压最大上升速率 (+LVdp/dtmax)等血流动力学指标的影响。结果　BaCl2 模型中 ,联合用药组较同剂量单用药组的心律失常发生率降低 ,持续时间缩短。乌头碱模型中 ,联合用药组较同剂量单用药组的乌头碱剂量增大。血流动力学结果显示 ,iv 2mg·kg-1的普罗帕酮对麻醉大鼠心脏有明显的负性肌力作用 ,而与iv 5 0mg·kg-1牛磺酸合用时则无明显的负性肌力作用。结论　牛磺酸和普罗帕酮对BaCl2 及乌头碱诱发的室性心律失常有抗心律失常作用 ,二者合用作用增强 ;小剂量牛磺酸与普罗帕酮合用可克服普罗帕酮的心功能抑制作用     

稳心颗粒治疗老年心律失常52例疗效观察

目的观察稳心颗粒治疗老年心律失常的临床疗效及不良反应。方法将104例经心电图证实有心律失常的老年患者随机分为稳心颗粒组（治疗组,52例）与普罗帕酮（心律平）组（对照组,52例）,治疗4周。结果治疗组心悸症状缓解总有效率93.5%,对照组心悸症状缓解总有效率为83.3%,且治疗组对心悸、睡眠不安、胸闷症状缓解的总有效率优于对照组（P〈0.05）,未见明显不良反应。治疗组治疗房性早搏总有效率为78.8%,对室性早搏的总有效率为82.7%。结论稳心颗粒可明显改善老年心律失常患者的临床症状,对房性早搏和室性早搏有一定的疗效。     

葡萄糖酸镁与门冬氨酸钾镁治疗心律失常的比较

目的：探讨葡萄糖酸镁的抗心律失常疗效。方法：１０８例心律失常病人采用随机、单盲对照方法分为葡萄糖酸镁治疗组７１例（男性３１例，女性４０例；年龄５５±ｓ１５ａ）和门冬氨酸钾镁对照组３７例（男性１９例，女性１８例；年龄５７±１３ａ），在原用抗心律失常药物欠佳的情况下，分别加用葡萄糖酸镁和门冬氨酸钾镁各１０ｍＬ，ｐｏ，ｔｉｄ，４ｗｋ。结果：治疗组房性早搏和室性早搏的总有效率分别为６５％及７９％，与对照组的５８％和７２％相似，Ｐ＞０．０５。动态心电图检查显示２药应用后房性早搏和室性早搏数均明显减少。结论：葡萄糖酸镁可作为抗心律失常的辅助药物。     

参松养心胶囊治疗室性早搏的疗效观察

目的 观察参松养心胶囊治疗不同病因室性早搏的疗效与安全性。方法选择心功能NYHAⅠ～Ⅲ级的室性早搏患者136例,采用多中心随机对照为治疗组（76例）和对照组（60例）,治疗组口服参松养心胶囊4粒,3次／d;对照组Ⅵ服心律平150mg,3次／d,疗程4周。观察2组患者室性早搏的总有效率、症状改善率及安全性。结果治疗组总有效率为92．1％,症状改善率为86．8％;对照组总有效率为73．3％,症状改善率63．3％。2组比较差异有统计学意义（P〈0．05）,治疗组室性早搏疗效和临床症状改善优于对照组。结论参松养心胶囊对不同病因的室性早搏有明显疗效,且无严重不良反廊。     

依那普利联合美托洛尔治疗扩张型心肌病的临床疗效

目的探讨依那普利联合美托洛尔治疗扩张型心肌病的临床疗效。方法选取上海市东方医院南院2018年1月—2019年1月收治的扩张型心肌病患者68例,随机分为对照组与观察组,每组34例。对照组予以依那普利治疗,观察组在对照组基础上联合美托洛尔治疗。2组均连续治疗3个月。比较2组临床疗效,治疗前后心功能指标[左心室舒张期末内径(LVEDD)、左心室收缩期末内径(LVESD)、左心室射血分数(LVEF)]、心率、房性期前收缩次数、室性期前收缩次数、短阵室速阵数,并观察2组不良反应发生情况。结果观察组总有效率高于对照组(P<0.05)。治疗前2组LVEDD、LVESD、LVEF比较,差异无统计学意义(P>0.05);治疗后观察组LVEDD、LVESD低于对照组,LVEF高于对照组(P<0.05)。治疗前2组心率、房性期前收缩次数、室性期前收缩次数、短阵室速阵数比较,差异无统计学意义(P>0.05);治疗后观察组心率、房性期前收缩次数、室性期前收缩次数、短阵室速阵数低于对照组(P<0.05)。2组均未发生严重不良反应。结论依那普利联合美托洛尔治疗扩张型心肌病的临床疗效确切,可有效改善患者心功能与心电图指标,且安全性较高。     

Oral tocainide versus disopyramide: a double-blind, randomized, crossover study of outpatients with stable ventricular premature beats

Oral tocainide and disopyramide were compared in a double-blind, crossover trial in 10 outpatients with stable ventricular premature beats (VPBs). Efficacy was assessed by suppression of VPB activity and reduction of VPB grade during an exercise test and an 18-h Holter recording. An estimate of variance of VPB activity was obtained from two separate placebo periods, and a 95% confidence limit for VPB suppression was calculated. During Holter recording, both drugs produced a significant reduction in VPB frequency and grade (p less than 0.05). During the exercise challenge, tocainide produced a reduction in VPB frequency and grade, but this did not reach statistical significance; VPB frequency was unaltered by disopyramide, but VPB grade was significantly reduced (p less than 0.01).     

Magnesium deficiency may be an important determinant of ventricular ectopy in digitalised patients with chronic atrial fibrillation.

Digitalised patients with chronic atrial fibrillation (AF) have a high prevalence of ventricular premature beats (VPB); magnesium deficiency may be a contributory factor. We have used a magnesium loading-test to examine the relationship between ventricular ectopy and magnesium status in 14 digitalised patients with chronic AF. Among seven patients with infrequent VPB (less than 250 24 h-1; mean 107 24 h-1) mean magnesium retention was 10.1% and four subjects retained no significant quantities of magnesium, indicating magnesium repletion. Among the remaining seven patients, mean magnesium retention was significantly higher (33.1%, P less than 0.02) and all patients retained 20% or more of the load given. There was an overall relationship between Mg retention and numbers of VPB (rs = 0.54; P less than 0.05). Magnesium deficiency may be determinant of ventricular ectopy in digitalised patients with chronic AF.     

Acute effects of antiarrhythmic drugs on stable ventricular premature beats

Summary Nineteen patients with refractory but stable ventricular premature beats (VPB) received 3 medications intravenously at 24-h intervals. Lorcainide (2 mg/kg) and placebo were given double-blind in randomized sequence and the third treatment was 100 mg lidocaine, the standard reference drug. Continuous ECG recordings were made for the first 2 hours after administration to study the antiarrhythmic effect; the stability of the arrhythmia, the absence of residual and of period effects, and the interdrug differences in efficacy were statistically evaluated. Lorcainide significantly reduced the frequency of VPB during the 2-hour period, whereas the effect of lidocaine was more short-lived. The median individual peak reduction in VPB was 96% for lorcainide and 47% for lidocaine. No significant reduction in VPB was observed with placebo. Adverse effects were acceptable with either active treatment.     

Frequent ventricular premature beats increase blood pressure variability in rats

INTRODUCTIONBlood pressure variability (BPV) is increased inseveral conditions, including hypertension[1-3], aging[4],diabetes[5,6], spinal cord injury[7], and alcohol consump-tion[8], and linked with the severity of the underlyingdiseases, such as hypertension[1,2]. Causes for high BPVare manifold and varied in different conditions. It iswell known that arterial baroreflex is important in thestabilization of blood pressure (BP), and interruption ofarterial baroreflex by sinoaortic d…     

动态心电图与常规心电图诊断孕妇心律失常的临床对比

目的比较常规心电图、动态心电图在诊断孕妇心律失常方面的价值。方法80例心律失常孕妇,均接受动态心电图和常规心电图检查,比较两种检查方法对各类心律失常的检出率。结果动态心电图对房性早搏成对、房性早搏二三联律、室性早搏成对、室性早搏二三联律、短阵室上性心动过速的检出率分别为11.25%、13.75%、33.75%、83.75%、11.25%,均高于常规心电图的2.50%、3.75%、3.75%、33.75%、2.50%,差异具有统计学意义(P<0.05)。两种检查方法对房室传导阻滞的检出率比较差异无统计学意义(P>0.05)。结论动态心电图在孕妇心律失常诊断中准确率更高,能很好的协助诊疗,临床应用价值高。     

Actions of flecainide on susceptibility to phase-2 ventricular arrhythmias during infarct evolution in rat isolated perfused hearts

The mechanism of flecainide-induced unexpected death remains uncertain. Phase-2 ventricular arrhythmias occur during infarct evolution. We examined whether flecainide (0.74 and 1.48 microM, representing the peak unbound plasma and total blood concentrations, respectively, at 'therapeutic' dosage) has proarrhythmic activity on phase-2 arrhythmia susceptibility during infarct evolution.To achieve this, we used the Langendorff-perfused rat heart preparation (n=8 per group) in which baseline phase-2 arrhythmia susceptibility is low. Left main coronary occlusion evoked phase-1 (acute ischaemia-induced) ventricular arrhythmias including fibrillation (VF) in all hearts. By 90 min, hearts were relatively arrhythmia-free.Randomized and blinded switch of perfusion to flecainide at 90 min caused no increase over baseline in the incidence of VF, tachycardia (VT) or premature beats (VPB) during the following 150 min of ischaemia, or during reperfusion (begun 240 min after the onset of ischaemia).In separate hearts, catecholamines (313 nM norepinephrine and 75 nM epinephrine) were co-perfused with flecainide from 90 min of ischaemia. Catecholamine perfusion increased heart rate, coronary flow and QT interval, and shortened PR interval (all P<0.05), actions that were not altered by flecainide. Catecholamine perfusion caused a weak nonsignificant increase in phase-2 VPB, VT and VF incidence, but there was no proarrhythmic interaction with flecainide.In conclusion, the present findings suggest that the increased risk of death associated with clinical use of flecainide is not due to facilitation of phase-2 ventricular arrhythmias.     

稳心颗粒治疗冠心病心律失常65例疗效分析

目的:探讨稳心颗粒治疗冠心病心律失常的疗效。方法:将65例冠心病心律失常患者随机分为观察组33例,对照组32例。观察组口服稳心颗粒。1包(9g),tid;对照组口服心律宁,3片,tid。疗程为4周。观察服药前及服药后1周、2周、3 周、4周心电图、心脏超声、心功能、血液流变学的变化。结果:稳心颗粒组明显减少冠心病心律失常尤其是房性早搏、室性早搏的发生率(P<0．05),对心功能也有一定的改善作用。结论:稳心颗粒具有显著的抗心律失常作用,且无明显不良反应,安全性好。