地尔硫卓联合大剂量美托洛尔治疗主动脉夹层

Diltiazem in combination with metoprolol for treating aortic dissection

目的观察地尔硫卓静脉内给药联合美托洛尔治疗主动脉夹层的临床疗效。方法宜昌市第一人民医院2005年6月至2008年1月收治的主动脉夹层患者14例（男性10例，女性4例）。地尔硫卓针剂（合贝爽静脉注射液）以1～5μg/（kg．min）静脉泵入，同时联合使用美托洛尔（400mg/d）。观察用药后30min，60min，120min，6h，1d，7d血压、心率变化情况。数据比较采用自身配对t检验。结果用药后60min心率显著下降，比用药前下降了（21±5）次／min，总有效率达到100％，用药后30min收缩压、舒张压明显下降。用药后6h收缩压降至（126．2±11．1）mmHg，舒张压降至（80．3±8．1）mmHg。无明显药物副作用出现。结论地尔硫卓针剂静脉内注射联合美托洛尔治疗急性主动脉夹层安全有效。

Objective To explore the clinical therapeutic effects of intravenous infusion of dihiazem in combination with metoprolol for treating aortic dissection. Method From June 2005 to January 2008, fourteen patients with aortic dissection （ male 8, female 4） in the First Hospital of Yichang, were treated with dihiazen 1 - 5μg/（ kg·min） by intravenous infusion in combination with 400 mg/d lnetoprolol. The changes of blood pressure and heart rate 30 min, 60 min, 120 min, 6 h, 1 d and 7 d after treatment were recorded. All data were analyzed using selfmatching t test. Results The heart rate reduced significantly 60 min after treatment. The heart rate reduced （21 - 5） beats/min from the baseline. The total effective rate was 100%. The blood pressm＇e reduced significantly 30 min after treatment. The systolic pressure reduced to （126.2 ± 11.1） mmHg and diastolic pressure declined to （80.3 ± 8.1） mmHg. No severe cardiac side-effect observed. Conclusions Diltiazem in combination with metoprolol can reduce heart rate and blood pressure markedly and safely in aortic dissection patients.