倍他乐克注射液对快室率房颤伴心衰的疗效观察.docVIP

倍他乐克注射液对快室率房颤伴心衰的疗效观察 作者：凌峰 作者单位：杭州市第一人民医院，浙江杭州 310006 【摘要】 目的 探讨倍他乐克注射液联合西地兰对房颤快速心室率伴心衰的疗效及安全性。方法 对房颤伴心衰的患者，先给以西地兰0.2mg稀释后缓慢静注，观测半小时，如心率仍＞100次/分、血压≥100/60mmHg以上的患者，予倍他乐克注射液10mg稀释后经微泵静注1小时，当心率≤60次/分、血压＜90/60mmHg时停止；微泵静注倍他乐克前、后，观察症状、体征、心率、血压、肺部音、无创血流动力学和BNP、ANP等指标。结果 用倍他乐克后心室率平均减少了23.73次/分(Ｐ＜0.01)，收缩压降低5.69mmHg(Ｐ＜0.05)，舒张压降低5.26mmHg(Ｐ＜0.05)，使用倍他乐克前后SI、SV、VI、SVRI、SVR、LVET有明显改变(Ｐ＜0.05)，BNP、ANP无显著变化。结论 倍他乐克注射液联合西地兰治疗快室率房颤伴心衰是有效和安全的。 【关键词】 倍他乐克注射液 西地兰 快室率房颤 心力衰竭 The Efficacy of Intravenous Metoprolol on Heart Failure with Atrial Fibrillation of Rapid Ventricular Rates. LING Feng, PENG Wen-hui, YANG Jun, et al. Department of Cardiology, Hangzhou the First Peoples Hospital, Zhejiang 310006, China ［Abstract］ Objective To observe the efficacy and safety of intravenous metoprolol combined with cedilanid (lanatoside C) in treatment of patients with heart failure of atrial fibrillation of rapid ventricular rates.Methods Patients with heart failure of atrial fibrillation of rapid ventricular rates were first administrated cedilanid and observed half an hour, if ventricular rate was still above 100 beats/min and blood pressure was above 100/60 mmHg, then the patients were given metoprolol 10mg by minipump in an hour. When either ventricular rate was≤60 beats/min or blood pressure＜90/60 mmHg, intravenous metoprolol was stopped. Before and after metoprolol treatment, the symptom and physical sign, heart rate, blood pressure, the rale, the blood rheology, BNP and ANP were examined.Results The heart rate decreased by 23.73 beats/min (Ｐ＜0.01), and SBP lowed by 5.69 mmHg (Ｐ＜0.05), DBP lowed by 5.26 mmHg (Ｐ＜0.05) after metoprolol treatment. There were significant changes in SI, SV, VI, SVRI and LVET (Ｐ＜0.05), however, BNP and ANP had no changes after metoprolol treatment.Conclusions Intravenous metoprolol combined with cedilanid is safe and effective in treating heart failure with atrial fibrillation. ［Key words］ Metoprolol injection; Cedilanid; At