合贝爽地尔硫卓注射剂的临床应用.ppt

* * * * * * * * * * * * * * 用药前后48小时内心绞痛发作减少的次数如左图，发作持续时间用药前后对比见右图 * 静脉点滴收缩压、舒张压显著下降，心率也平稳下降 * 心绞痛减少次数——随着给药量的增加，减少次数逐步增加 心率变化——随着给药剂量加大，心率下降幅度增加，但是下降到正常心率时下降不再明显 收缩压舒张压——随着给药剂量加大血压逐步下降，但是下降到正常值时下降不再明显 * 给药48小时内心绞痛发作次数及发作时间的对比情况，两族给药前后有显著性差异，均有效 但两组间没有显著性差异 * 地尔硫卓组明显可以比硝酸甘油降低心率 * 两组均可以有效降低血压 * 所以地尔硫卓可以比硝酸甘油明显降低率压积，降低心肌耗氧指数，对心绞痛病人治疗有益 * 随着给药剂量的加大，有效率逐步上升 * 在此试验中，收入了心功能1-4级的患者 * 用药前心室率为141，静脉推注后下降到102，静脉点滴后达到82，总有效率为94.3% * 静脉注射后对血压的影响见左图，血压显著降低 静脉点滴后对血牙的影响见右图，收缩压下降明显，舒张压已经达到正常值，所以给药后不会造成血压的过度下降 * 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 re