地尔硫卓治疗难治性不稳定心绞痛38例的临床观察  

Diltiazem in Treatment of Refractory Unstable Angina Pectoris:Clinical Observation of 38 Cases

作　　者：张继晨[1] 

机构地区：[1]河南省新乡市中心医院,453000

出　　处：《职业与健康》2009年第11期1214-1216,共3页Occupation and Health

摘　　要：目的探讨地尔硫卓对难治性不稳定心绞痛的疗效和安全性。方法38例对常规抗心绞痛和抗栓治疗无效的不稳定心绞痛患者,停用硝酸酯和美托洛尔,改用静脉持续泵入地尔硫卓72h治疗。控制逐渐滴定地尔硫卓的剂量。观察治疗前后心绞痛发作、发作时ST段压低及血流动力学指标的变化,并注意药物不良反应。结果地尔硫卓治疗后,心绞痛得到有效控制,总有效率92.1%。与治疗前比较,治疗后的平均心绞痛发作次数、每次发作持续时间、发作时ST段压均明显降低(均P<0.01);治疗后24、48和72h的血压、心率(均P<0.05)和收缩压×心率均明显降低(P<0.01),未发现严重不良反应。结论地尔硫卓静脉泵入治疗难治性心绞痛安全、有效,但需严格控制滴定药物剂量。[ Objective] To investigate the efficacy and safety of diltiazem to refractory unstable angina pectoris. [ Methods ] 38 unstabXe angina patients, who were failed to conventional anti-angina pectoris and antithrombotic treatment, were treated with continuous infusion of intravenous diltiazem for 72 hours instead of nitrate and metoprolol. Gradual titration of dittiazem was controlled. Angina attack, ST segment depression and changes in blood rheologic indexes were observed before and after treatment. [ Results] The attack of angina was effectively controlled after diltiazem treatment. The total effective rate was 92.1%. The average attack frequency, average attack duration and depression of ST segment were significantly decreased after dihizaem treatment （ P 〈 0.01 ）. The blood pressure, heart rate （ P 〈 0.05）and the systolic blood pressure x heart rate significantly decreased（ P 〈 0.01 ） at 24,48 and 72 hour after diltizaem treatment, without serious adverse reactions. [ Conclusion] It was effective and safe to treat refractory unstable angina pectoris with diltizaem intravenous injection, but the dose titration should be strictly controlled.

关 键 词：难治性不稳定心绞痛 地尔硫卓 疗效 安全性 

分 类 号：R541.4[医药卫生—心血管疾病]