钙通道阻滞剂中毒治疗进展

Progress in Treatment of Calcium Channel Blocker Poisoning

钙通道阻滞剂(CCBs)广泛应用于高血压、心绞痛、心律失常和其他疾病的治疗。但CCBs的潜在毒性较大,严重中毒患者死亡率较高。CCBs中毒后临床可表现为心血管毒性和非心血管毒性。CCBs中毒治疗包括早期一般处理、毒物的清除、给予钙盐和大剂量胰岛素等药物以及安置心脏起搏器等方法。静脉注射脂肪乳剂和静脉-动脉体外膜氧合在CCBs中毒治疗中也发挥重要作用。磷酸二酯酶抑制剂、钙增敏剂等药物已被提出作为新的治疗药物,但其有效性仍需要进一步证实。

Calcium channel blockers(CCBs)are widely used in the treatment of hypertension,angina pectoris,arrhythmia and other diseases.However,the potential toxicity of CCBs is high,and the mortality of patients with severe poisoning is high.The clinical manifestations of CCBs poisoning include cardiovascular toxicity and non-cardiovascular toxicity.The treatment of CCBs poisoning includes early general treatment,elimination of the poison,administration of calcium salt,high-dose insulin and placement of cardiac pacemaker.Intravenous fat emulsion and venous-arterial extracorporeal membrane oxygenation also play an important role in the treatment of CCBs poisoning.Phosphodiesterase inhibitors,calcium sensitizers and other drugs have been proposed as new therapeutic drugs,but their effectiveness still needs to be further confirmed.