静脉点滴5-单硝异山梨酯治疗重症充血性心力衰竭的临床疗效

Efficacy of Intravenous Isosorbide Mononitrate in the Treatment of Congestive Heart Failure

目的:观察静脉点滴5-单硝异山梨酯治疗充血性心力衰竭的临床疗效。方法:29例充血性心力衰竭患者静脉应用5-单硝异山梨酯持续静点。平均维持量140.68±36.83μg/min,观察心衰体征、心功能分级改善情况、达个体最大维持量时和治疗后血压、心率及副作用。结果:29例患者中27例NYHA心功能分级有改善(有效率93.1％),体位、肺部湿罗音、下肢浮肿、肝脏肿大的体征改善率分别为79.31％、62.06％、51.72％和55.17％。用药前收缩压为149.62±23.90mmHg,舒张压为86.48±11.28mmHg,达个体最大维持量时和用药后分别降至130.17±14.71mmHg、12.68±13.02mmHg;75.27±6.78mmHg、73.06±7.58mmHg。心率由107.10±11.40次/分下降至85.00±6.96次/分、81.34±7.61次/分(P<0.05)。其中1例患者出现轻微头疼。结论:静脉5-单硝异山梨酯对重症充血性心力衰竭有良好疗效。

Objective: To evaluate the clinical therapeutic effectiveness of intravenous isosorbide mononitrate in the treatment of congestive heart failure. Method: 29 patients with congestive heart failure were involved in the study. Isosorbide mononitrate was continuously administered intravenously. The average maintenance dose was 140. 68 ±36. 83μg/min. The improvement of signs of heart failure and the grading of cardiac function, blood pressure and heart rate at the maximal maintenance dose for each patient and after the treatment and the side effects were evaluated. Results: There were improvement of NYHA cardiac function grading in 27of the 29 patients (effective rate 93. 10% ) . The improvement rate for posture, rales, edema of the lower extremities and hepatomegaly was 79. 31%, 62. 06% ,51. 72% and 55. 17% respectively. Before the treatment, systolic and diastolic blood pressure was 149. 62 ±23.90mmHg and 86.48 ±11. 28mmHg respectively, and was reduced to 130.17 ±14.71mmHg and 75, 27 ±6. 78mmHg at the maximal maintenance dose and 124. 68±13.02mmHg and 73. 06 ± 7. 58mmHg after the treatment respectively. Heart rate decreased from 107. 10 ±11.40bpm before the treatment to 85. 00±6. 96bpm at the maximal maintenance dose and 81. 34 ±7. 61bpm after the treatment (P < 0. 05). Of all the 29 patients, only 1 patient developed mild headache in the treatment. Conclusion: Isosorbide mononitrate is ef fective in the treatment of severe congestive heart failure.