西地兰对老年阵发性房颤复律效果与左心功能的关系

Relationship between left ventricular function and the defibrillation effect of deslanoside in paroxysmal atrial fibrillation in the elderly

目的明确老年阵发性心房纤颤（ＰＡｆ）患者发作间歇期的心功能状态与西地兰复律效果的关系，为选择复律适应证提供依据。方法对６５例原发病为冠心病（ＣＨＤ）、高血压（ＨＰＴ）及不明原因（ＩＤＰ）的老年ＰＡｆ患者，使用西地兰复律，并用超声心动图检测发作间歇期心功能，分析两者的关系。结果（１）有效组原发病以ＣＨＤ及ＣＨＤ伴ＨＰＴ为主，大多兼有左室收缩功能障碍（ＳＩ），推测西地兰的正性肌力作用参与了ＰＡｆ伴ＳＩ患者的复律机制。（２）无效组原发病以ＨＰＴ为主，大多兼有左室舒张功能障碍（ＤＩ）。（３）老年有效组中有少数单纯ＤＩ及心功能正常者，推测西地兰的迷走神经兴奋作用可能参与了ＰＡｆ伴ＤＩ患者的复律机制。结论ＣＨＤ伴ＳＩ为西地兰复律的良好适应证。

Objective To explore the indication of deslanoside defibrillation in paroxysmal atrial fibrillation (PAf). Methods The relationship between the defibrillation effect of deslanoside and the left ventricular function detected with echocardiography at the interval of the PAf attacks was observed in 65 elderly patients with coronary heart diseases (CHD), hypertension(HPT), and patients without any detectable primary cardiovascular disorders(idiopathic IDP). Results (1)Deslanoside was effective in most elderly PAf patients suffering from CHD or CHD and HPT with systolic insufficiency(SI).These patients are suitable for defibrillation with deslanoside. (2)Deslanoside was not effective in PAf patients suffering from HPT with diastolic insufficiency (DI). these patients are not suitable for defibrillation with deslanoside. (3)Deslanoside was effective in a few elderly PAf patients with lonely DI or with no detectable cardiac insufficiency, probably the parasympathetic effect of deslanoside participated in its defibrillation action. Conclusions PAf patients with CHD and SI are suitable for defibrillation with deslanoside but patients with HPT and DI are not.