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目的观察静脉滴注地尔硫卓治疗老年不稳定型心绞痛的临床疗效及安全性。方法76例老年不稳定型心绞痛患者停用硝酸酯类制剂、β受体阻滞剂及其他抗心肌缺血药物,静点地尔硫卓100~300μg/min持续48h,观察血压、心率、疗效和不良反应。结果用药开始后48 h内,41例患者未再发作心绞痛,22例明显改善,8例有所改善,5例无效。治疗开始后48h较24h NST和∑ST有进一步下降,但无统计学差异。用药后,HR减慢,SBP和DBP均有下降,SBP下降幅度大于DBP。5例出现窦性心动过缓,4例低BP,将地尔硫卓减量后均好转。结论静脉滴注地尔硫卓能使心绞痛短时间内明显缓解,发作次数明显减少且持续时间明显缩短;同时地尔硫卓还使心电图ST变化得到一定程度改善;副作用小,无严重不良反应,安全性高,是可供临床采用的一种新的药物治疗手段。
Objective To observe the clinical efficacy and safety of intravenous diltiazem in the treatment of unstable angina pectoris in the elderly. Methods 76 elderly patients with unstable angina pectoris were discontinued nitric ester preparations, β-blockers and other anti-myocardial ischemia drugs, intravenous diltiazem 100 ~ 300μg / min for 48h, observed blood pressure, heart rate, efficacy and adverse reactions . Results Within 48 hours after the initiation of medication, 41 patients had no further angina pectoris, 22 improved significantly, 8 improved and 5 failed. 48h after treatment began to decline further than 24h NST and ΣST, but no statistical difference. After treatment, HR slowed, SBP and DBP decreased, SBP decreased more than DBP. 5 cases of sinus bradycardia, 4 cases of low BP, will be diltiazem reduction after all improved. Conclusion Intravenous diltiazem can relieve angina pectoris in a short period of time, significantly reduce the number of episodes and shorten the duration significantly; meanwhile, diltiazem also improves ST changes to a certain degree; with few side effects, no serious side effects and high safety For clinical use of a new drug treatment.