老年肺心病心衰伴快速房颤的临床疗效观察

A Clinical Study on the Efficacy of Intravenous Diltiazen in Elderly Heart Failure Patient with COPD and Rapid Atrial Fibrillation

目的比较老年肺心病中重度心功能衰竭伴快速房颤的患者静脉注射地尔硫卓及西地兰控制心室率的临床疗效和安全性。方法采用随机单盲方法,将60例老年肺心病合并中重度心功能衰竭伴快速房颤患者分为2组,分别给予地尔硫卓和西地兰静脉注射,观察控制心室率的有效率及临床症状和体征的变化。结果地尔硫卓组控制心室率有效率为93.6%,西地兰组有效率为82%;用药前后对比肺动脉压力,地尔硫卓组较西地兰组下降更显著。两组均有2例出现无症状性低血压,自行恢复,两组均未出现明显临床及实验室不良反应。结论静脉注射地尔硫卓能有效地控制老年肺心病中重度心衰伴快速房颤患者的心室率,降低肺动脉压力,改善血液动力学,从而改善患者心功能及临床症状,在急性期优于西地兰,且相对安全。

Objective To evaluate the clinical efficacy and safety of intravenous diltiazen and cedilanid for treatment of rapid ventricular rate in elderly heart failure patient with COPD and rapid atrial fibrillation.Methods A single-blind,randomized study about the rate of controlling ventricular rate and clinical symptoms on 60 elderly heart failure patients with COPD and rapid atrial fibrillation was conducted by comparing intravenous diltiazen and cedilanid.Results The efficacy of controlling ventricular rate was 93.6 % in the diltiazen group;simultaneously,the efficacy was 82% in the cedilanid group;The decrese of pulmonary pressure is more obervious in diltiazen group than cedilanid group;There were 2 patients having low pressure without symptom in both groups.and recovering automaticly.There were no evident clinical and testy side effect n both groups.Conclusion It is effective to controlling ventricular rate,decreasing pulmonary pressure,improving blood stream dynamics,a clinical symptoms and heart function by intravenous diltiazen for treatment elderly heart failure patient with COPD and rapid atrial fibrillation.It is superior to cedilanid in acute period and relatively safety.