大剂量硝酸异山梨醇酯抢救急性心源性肺水肿的疗效观察

目的探讨大剂量硝酸异山梨醇酯治疗急性心源性肺水肿的疗效。方法317例急性心源性肺水肿患者，分为实验组和对照组。实验组采用静脉注射大剂量硝酸异山梨醇酯注射液并且静脉滴注维持，对照组按传统疗法治疗。包括利尿．应用糖皮质激素、氨茶碱等。观察2组临床症状、动脉血压、血氧饱和度的变化。结果治疗后实验组有效率89．3％，对照组有效率70．4％（P〈0．01）。实验组在呼吸困难的缓解、肺部水泡音的减少、死亡人数以及血氧饱和度方面明显优于对照组，但2组在心率、呼吸频率上未见明显差异，治疗中均无急性心肌梗死出现，未见其他严重副作用。结论静脉注射大剂量硝酸异山梨醇酯抢救急性心源性肺水肿是一有效、安全的新疗法。

High-dose isosorbide dinitrate in acute cardiac pulmonary edema

Objective To explore the effects of high dose isosorbide dinitrate in acute pulmonary edema. Methods 317 acute pulmonary edema patients were randomly divided into group A,who received isosorbide dinitrate intravenously and group B,who received routine therapy (intravenous furosemide and morphine bolus).Oxygen saturation,blood pressure and clinical symptoms were observed.Results The effective rates after treatment in group A was higher than that in group B (89.3% vs.70.4%,P<0.01); Oxygen saturation,relief of dyspnea,decrease of pulmonary bubbling and death toll were superior to those of control group,but there was no significant difference in heart beat and breath frequency between groups.No acute myocardial infarction occurred in the two groups.Conclusion High dose isosorbide dinitrate is safe and effective in treating severe acute pulmonary edema.