硫酸镁治疗心力衰竭患者室性早搏的疗效

Clinical study of magnesium sulfate therapy on ventricular premature contractions in patients with chronic heart failure

目的探讨静脉滴注硫酸镁对心力衰竭患者室性早搏的治疗效果。方法对31例血清镁≤1.9mg/dl、室性早搏>10次/h的慢性充血性心力衰竭患者给于硫酸镁(0.2mEq/kg)静脉滴注,比较滴注前后血清镁浓度变化与6h动态心电图记录的室性早搏频率变化的关系。结果血清镁浓度与室性早搏频率呈负相关(r=-0.82,P<0.01)。血镁浓度增加≥0.7mg/dl的患者,室性早搏频率下降(309±241)次/h,而增加<0.7mg/dl的患者,室性早搏频率是多变的。滴注前平均室性早搏频率为(405±366)次/h,滴注后为(214±165)次/h(P<0.01)。滴注前室性早搏频率<220次/h的患者,滴注后室性早搏频率无明显改变,分别为(126±45)次/h及(120±113)次/h,P>0.05。结论静脉滴注硫酸镁对于心力衰竭伴有频发室性早搏患者有明显降低室性早搏频率的作用,其机制与血清镁浓度快速增加有关。

Objective To investigate the therapeutic effect of magnesium sulfate on ventricular premature contractions （VPC） in patients with chronic heart failure. Methods The magnesium sulfate were administrated intravenously（0. 2 mEq/kg）in 31 patients with chronic congestive heart failure and serum mganesium ≤ 1.9 mg/dl and frequency of VPC 〉 10 beats/h. The correlation between serum magnesium concentration and frequency of VPC in 6 hours Hoher recording were compared before and after administration. Results The serum magnesium concentration were correlated negatively with the frequency of VPC（ r = -0. 82 ,P 〈0. 001 ）. The frequency of VPC decreased（309 ± 241 ） beats/h in patients with serum magnesium concentration increasing ≥0. 7 mg/dl; but thefrequency of VPC were changeful in patients with 〈 0. 7 mg/dl. The average frequency of VPC were （405 ± 366） beats/h and （ 214 ± 165 ） beats/h respectively before and after administration（ P 〈 0. 01 ）. The frequency of VPC didn＇ t change significantly in patients with the frequency of VPC ≤220 beats/h before and after administration[ （126 ± 45 ）beats/h and（ 120±113 ）beats/h respectively,P 〉0. 05）]. Condusion The frequent VPC may be decreased by intravenous magnesium sulfate in patients with chronic heart failure; its mechanisms were correlated with serum magnesium concentrations increasing rapidly.