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出 处:《中国新药杂志》2006年第22期1969-1971,共3页Chinese Journal of New Drugs
摘 要:目的:观察60例急性心肌梗死(AMI)患者在发病早期应用前列地尔脂微球载体注射液(Lipo-PGE_1)治疗对QTc离散度(QTcd)的影响。方法:60例AMI患者随机分为前列地尔治疗组(n=31)和对照组(n=29)。治疗组在常规治疗基础上加用Lipo-PGE_1,疗程3周;对照组只采用常规治疗方法。记录每例患者入院后用药前和用药后第1,2,3,12,24 h和d3的12导联心电图测定QTcd。结果:入院后给药前测定QTcd治疗组与对照组间差异无显著性[(87.2±125)vs(86.9±11.3)ms,P>0.05],前壁与下壁梗死之间QTcd差异无显著性[(87.2±12.5)vs (86.7±12.1)ms,P>0.05]。治疗组在用Lipo-PGE_12 h时QTcd较对照组开始显著降低[(78.5±12.6)vs(87.8±13.6)ms,P<0.05],24h起QTcd较对照组极显著降低[(66.3±11.3)vs(88.1±13.2)ms,P<0.01]。治疗组有8例出现室性心律失常,在应用Lipo-PGE_12h后7例消失。结论:Lipo-PGE_1在AMI发病早期应用可降低QTcd,从而减少恶性心律失常发生,减少AMI的死亡率。Objective : To evaluate the prophylaxis of QT intervals dispersions (QTcd) with alprostadil injections ( Lipo-PGE1 ) in patients with initial stage of acute myocardial infarction ( AMI ). Methods: 60 AMI inhospitalized patients were randomly treated with either conventional regimen (n = 29) or conventional regimen plus alprostadil injection (n = 31 ) for 3 weeks. The patients underwent a 12-lead ECG to monitor the QTcd pre-therapy and in 1, 2, 3, 12, 24 hours and day 3 post-therapy. Results: Compared to the conventional therapy of (87.8 ± 13.6) ms, the patients adding on PGE1 initiated the significant reduction of QTed in 2 hours post-therapy (78.5 ±12.6)ms. (P 〈 0.05 ). The QTcd of the patients injecting PGE1 was (66.3 ± 11.3) ms in 24 hours post-therapy, compared with the conventional therapy of (88.1± 13.2) ms (P 〈 0.01 ). The PGE1-treated patients experienced ventricular arrhythmias (8 out of 31 patients), of which 7 incidences were recovered when patients continued the PGE1 therapy for more than 2 hours. Conclusion: Administration of alprostadil at the early stage of AMI episode was beneficial in the reduction of the incidence of malignant arrhythmia and mortality due to AMI.
关 键 词:QTC离散度 心肌梗死 前列地尔脂微球载体注射液
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