维持量地高辛间歇疗法治疗窦性心律心力衰竭的疗效评价

目的　评价维持量地高辛间歇疗法治疗窦性心律心力衰竭的临床疗效。方法　 113例窦性心律心力衰竭患者随机分为二组 :A组 :5 6例采用间歇维持量地高辛治疗 ;B组 5 7例采用持续维持量地高辛治疗。结果　两组患者治疗前与治疗 3个月和 8个月比较左心室射血分数 (LVEF ,A组分别为 0 3 6± 0 12 ,0 4 2± 0 11,0 4 4± 0 14 ;B组分别为 0 3 6± 0 15 ,0 4 3± 0 13 ,0 4 5± 0 15 ) ,心室率(HR ,次 /min ,A组分别为 98± 15 ,76± 16,74± 14 ;B组分别为 10 0± 12 ,75± 12 ,75± 16)治疗后与治疗前比较差异均有显著性 (P <0 0 1) ,二组间比较差异无显著性 (P >0 0 5 ) ;地高辛过量或中毒的发生率两组差异有显著性 (P <0 0 1)。结论　间歇维持量地高辛疗法可降低洋地黄过量或中毒的发生率 ,其疗效相似 ,可能是一种安全有效的临床给药方法。

Clinicalevaluation of intermittent maintenance digoxin therapy in congestive heart failure withsinus rhythm

Objective　To study the effects ofintermittent maintenance digoxin therapy in congestive heart failure with sinus rhythm. Methods　One hundred and thirteencongestive heart failure patients with sinus rhythm divided into group A (56 cases withintermittent maintenance digoxin treatment) and group B (57 cases with continuousmaintenance digoxin treatment) were observed for 8 months. Results　As compared with the pretreatmentdata, left ventricular ejection fraction (LVEF) and heart rate (HR) (LVEF 0.36±0.12 vs0.42±0.11 and 0.44±0.14 in group A, 0.36±0.15 vs 0.43±0.13 and 0.45±0.15 in group B;HR 98±15 vs 76±16 and 74±14 in group A, 100 ±12 vs 75±12 and 75±16 in group B,respectively) were significantly improved (P<0.01) at the 3rd and 8th month oftreatment. The total occurrence rate of digoxin overload or toxication in group A wassignificantly lower than those in group B (3.6% vs 12.3%, respectively (P<0.01). Conclusion　Intermittent maintenance digoxintreatment in congestive heart failure with sinus rhythm is effective and safe, with alower digitalis toxication occurrence compared with continuous maintenance digoxintreatment.