盐酸戊乙奎醚注射液联合酚妥拉明治疗围产期心肌病伴急性左心衰竭疗效分析

Efficacy of penehyclidine hydrochloride and phentolamine in patients with peripartum cardiomyopathy complicating acute left ventricular insufficiency.

目的对硝酸甘油和盐酸戊乙奎醚注射液加酚妥拉明治疗围产期心肌病伴急性左心衰竭的疗效和安全性进行观察、对比。方法随机将围产期心肌病急性左心衰竭患者68例分为硝酸甘油组、盐酸戊乙奎醚注射液加酚妥拉明组各34例，分别给予硝酸甘油微泵静脉注射、盐酸戊乙奎醚注射液肌注、酚妥拉明微泵静脉注射，观察比较两组患者用药后起效时间、缓解时间、治疗前后症状、体征变化情况。结果盐酸戊乙奎醚注射液加酚妥拉明组显效率79．39％、总有效率91．17％，均较硝酸甘油组显效率（38．23％）、总有效率（67．64％）明显增高（P〈0．01）。盐酸戊乙奎醚注射液加酚妥拉明组起效时间在用药后15～40min起效，硝酸甘油组在用药后25～60min起效，两组比较差异有统计学意义（P〈0．01）。硝酸甘油组平均住院（15．5±2．7）d，盐酸戊乙奎醚注射液加酚妥拉明组平均住院（9．3±1．6）d，差异有统计学意义（P〈0．01）。结论盐酸戊乙奎醚注射液联用酚妥拉明治疗围产期心肌病伴急性左心衰竭疗效较确切，平均起效时间及平均住院天数较硝酸甘油明显缩短；病情好转率较硝酸甘油明显增高。

Objective This study was aimed to investigate the efficacy and safety between penehyclidine hydrochloride/phentolamine and nitroglycerin in patients with peripartum cardiomyopathy complicating acute left ventrieular insufficiency. Methods Patients（ n = 68） with peripartum cardiomyopathy eonlpficating acute left ventricular insufficiency were randomized divided（ 1 ： 1 ） into receive the treatment of penehyclidine hydrochloride intramuscular injection/phentolamine micro pump intravenous injection（ group 1 ） or nitroglycerin micro pump intravenous injection（ group 2） , then assess the efficient time, symptom and sign of the two groups. Results Excellent effective rate and total effective rate significantly higher in group 1 than group2 （79.39% vs 38.23 % , 91.17 % vs 67.64% , respectively;P 〈 0.01 ）. After drug administration,the efficient time shorter in group 1 than group 2 significantly（ 15 -40 min vs 25 - 60 min,respectively; P 〈 0.01 ）. The average period of hospitalization of the two groups were （ 15.5 ± 2.7 ） days and （ 9.3 ± 1.6 ） days, respectively; （ P 〈 0.01 ）. Conclusion It can be obviously seen the efficacy of penehyclidine hydrochloride/phentolamine treatment in patients with peripartum eardiomyopathy complicating acute left ventricular insufficiency, the average efficient time and average period of hospitalization become shorter than control, effective rate higher than control.