毒毛旋花子苷K间歇疗法治疗冠心病心力衰竭的长期临床应用评价  

long-term clinical evaluation of intermittent strophanthin K therapy for congestive heart failure combined with coronary artery disease

作　　者：祁述善[1] 周胜华[1] 沈向前[1] 

机构地区：[1]中南大学湘雅二医院心内科,湖南长沙410011

出　　处：《中国医师杂志》2007年第3期319-321,共3页Journal of Chinese Physician

摘　　要：目的评价毒毛旋花子K间歇疗法（ISKT）治疗保持窦性心律的冠心病心力衰竭的疗效及可行性。方法200例窦性心律的冠心病心力衰竭患者分为2组：A组98例采用维持量地高辛治疗；B组102例采用ISKT。结果心率（HR）、左室射血分数（LVET）及血压（BP）治疗前与治疗后3个月比较，在A组分别为：88±12及68±12（次／min，P〈0．01）；0．32±12及0．40±12（P〈0．01）；126±21／90±6及128±21／80±15（mmHg，P〉0．05）；在B组分别为：90±10及70±11（次／min，P〈0．01）；0．32±0．10及0.48±0．10（P〈0．01）；128±20／91±7及110±10／76±10（mmHg，P〈0．01）。治疗3个月后2组间比较：HR（P〉0．05）；LVEF（P〈0．05），BP（P〈0．01）。B组的心功能有较好的改善，因心绞痛而服用的硝酸甘油量较少，2组洋地黄中毒或过量发生率的差异无统计学意义。结论对窦性心律的冠心病心力衰竭，ISKT是安全、有效、可行的一种治疗方法，间歇应用，不产生耐受性，长期应用，不增加毒性。Objective To evaluate the effects and safety of intermittent strophanthin K therapy （ISKT） for congestive heart failure combined with coronary artery disease with sinus rhythm. Methods Two hundred patients were divided into Group A （98 cases with mainte- nance dignxin therapy）and Group B （ 102 cases with ISKT）. They were studied for 3 months and some of them for longer period. Results Comparing the pretreatment data： （1）heart rate （ HR, bpm） ,（2）left ventricular ejection fraction （LVEF） ,（3）bloed pressure （ Bp, mmHg, calculated values as mean Bp for statistics）. In group A, item （1） and （2） were significantly improved （ item （1）88 ± 12 and 68± 12, P 〈0. 01 ; item （2）0. 32 ±0. 12 and 0. 40± 0. 12, P 〈 0. 01 ; item （3） showed no significant difference （ 126 ± 21/90 ± 6 and 128 ± 21/80 ± 5, P 〉 0. 05 ）. In group B, item （1）, （2） and （3）were significantly improved （ item （1）90 ± 10 and 70 ± 11, item （2） 0. 32 ± 0. 10 and 0. 45 ± 0. 10, item （3）128 ±20/91 ±7 and 110 ± 10/76 ± 10, the p valves were the same 〈0. 01 ）. As compared with the post treatment data of both group A and B, HR, showed no significant difference between the two groups （ P 〉0. 05）. LVEF, P 〈0. 05, and Bp, P 〈0. 01, showed significant difference between the two groups. It showed no significant difference in total occurrence rate of digitalis overload or toxication between two groups. Conclusion ISKT for congestive heart failure combined with coronary artery disease with sinus rhythm is effective and safe, with better improvement of heart function and Bp level.

关 键 词：毒毛旋花子甙类/治疗应用 冠状动脉疾病/并发症 心力衰竭 充血性/药物疗法 投药 口服 

分 类 号：R541[医药卫生—心血管疾病]