毛花甙C对阵发性心房颤动的复律效果与发作间歇期左心功能状态的关系  

Relation Between Left Ventricular Function at Remission of Paroxysmal Atrial Fibrillation and Defibrillation Effect of Deslanoside

作　　者：董果雄[1] 范洪亮[1] 任桂芝[1] 王雄[2] 李天东[3] 杜波 李传富 朱震[3] 

机构地区：[1]青岛医学院附属医院心内科 [2]山西医学院第一附属医院心内科 [3]青岛医学院附属心血管病医院心内科

出　　处：《中国循环杂志》1996年第12期712-715,共4页Chinese Circulation Journal

摘　　要：目的：研究非瓣膜病阵发性心房颤动（房颤）患者的左心功能与毛花甙Ｃ（西地兰）复律效果的关系。方法：１２４例阵发性房颤患者使用毛花甙Ｃ复律，用彩色多普勒超声心动图随访记录发作间歇期的心功能，观察复律效果与心功能的关系。结果：复律有效组（ｎ＝７１）与无效组（ｎ＝５３）之间左心室收缩功能（Ｐ＜０．００１）、舒张功能（Ｐ＜０．０５）分别有显著差异。有效组收缩功能障碍者占６１．９７％，射血分数在正常下限者（４５％～４９％）占３２．３６％，尚有少数左心室舒张功能障碍及心功能正常者；无效组舒张功能障碍者占８８．６８％，尚有少数收缩功能障碍及心功能正常者。有效组冠状动脉粥样硬化性心脏病（冠心病）患者占８８．７３％，无效组高血压患者占８１．１３％。结论：毛花甙Ｃ的强心作用与迷走神经兴奋作用可能分别参与了阵发性房颤伴有与不伴有左心室收缩功能障碍患者的复律机制；阵发性房颤伴有收缩功能障碍是毛花甙Ｃ复律良好的适应证。Objective:To study the relation between left ventricular function at the remission of paroxysmal atrial fibrillation (PAf) and the defibrillation effect of deslanoside in patients with no valvular heart disease. Methods:One hundred twenty four cases of PAf were treated with deslanoside and the left ventricular functions were detected with colour Doppler echocardiography. Results:The left ventricular systolic( p <0 001) and diastolic functions( p <0 05) were significantly different between the effective group( n =71) and the ineffective( n =53) group.In the effective group,61 97% of the patients had obvious systolic insufficiency (SI) and 32 36% had EF between 45% 49%,a few had diastolic insufficiency or normal cardiac function (NCF).In the ineffective group 88 68% had diastolic insufficiency,a few had SI or normal cardiac function.77 46% of the patients in the effective group had coronory heart disease,while 81 13% in the ineffective group had hypertension. Conclusion:The cardiotonic and parasympathetic stimulating effects of deslanoside probably take part in the defibrillation of PAf with and without SI respectively.Better indication for defibrillation with deslanoside is PAf with SI.

关 键 词：心房颤动 心功能 复律 毛花甙C 

分 类 号：R541.750.5[医药卫生—心血管疾病] R972.2[医药卫生—内科学]