课件：钙离子阻滞剂.ppt

* * * * * Diltiazem was administered at an initial bolus injection of 0.25 mg/kg over 2 minutes followed by a second bolus of 0.35 mg/kg if VR remained 90 bpm 15 minutes later, and then a maintenance infusion at 10 mg/hr for 24 hours. Digoxin was given at a bolus dose of 0.5mg, then 0.25 mg every 8 hours (i.e., 1.25 mg over 24 hours). This dosage is lower than the maximal recommended dose (1.5 mg over 24 hours) to adjust for the lower body weight (range, 40–60 kg) in our cohort of Chinese patients. Amiodarone was administrated at a loading infusion of 300 mg over the first hour followed by 10 mg/kg over 24 hours. This dosage is also lower than the maximal recommended dose (20 mg/kg over 24 hours) used for pharmacologic conversion of AF because this study was aimed to study the effect of amiodarone for VR control. * 6小时，合贝爽组即取得较好控制效果 * Diltiazem was administered at an initial bolus injection of 0.25 mg/kg over 2 minutes followed by a second bolus of 0.35 mg/kg if VR remained 90 bpm 15 minutes later, and then a maintenance infusion at 10 mg/hr for 24 hours. Digoxin was given at a bolus dose of 0.5mg, then 0.25 mg every 8 hours (i.e., 1.25 mg over 24 hours). This dosage is lower than the maximal recommended dose (1.5 mg over 24 hours) to adjust for the lower body weight (range, 40–60 kg) in our cohort of Chinese patients. Amiodarone was administrated at a loading infusion of 300 mg over the first hour followed by 10 mg/kg over 24 hours. This dosage is also lower than the maximal recommended dose (20 mg/kg over 24 hours) used for pharmacologic conversion of AF because this study was aimed to study the effect of amiodarone for VR control. * * * * * * * * * * * * * 备注：横坐标显示的是地尔硫卓的血药浓度，纵坐标是收缩抑制率，地尔硫桌在较小血药浓度10-7---10-6次方的时候就可以使冠脉达到完全收缩抑制，10-5次方式可以使大动脉扩张，而较大剂量时才作用于心肌，抑制心肌收缩。所以，地尔硫卓的抑制作用首先作用于冠状动脉，其次是外周血管，而对于心肌的作用非常弱，在临床应用时不必过分担心其对心肌收缩的抑制作用即其负性肌力作用．对于心功能 II级 的患者使用是安全的。 * * * * * * * * * * * * 地尔硫卓组明显可以比硝酸甘油降低心率 主要应用范围 房颤心室率控制 指南的变迁——2010年ESC房颤指南中，地尔硫卓控制房颤室率（ⅠA），2006年