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目的探讨静脉滴注硫酸镁对心力衰竭患者室性早搏的治疗效果。方法对31例血清镁≤1.9mg/dl、室性早搏>10次/h的慢性充血性心力衰竭患者给于硫酸镁(0.2mEq/kg)静脉滴注,比较滴注前后血清镁浓度变化与6h动态心电图记录的室性早搏频率变化的关系。结果血清镁浓度与室性早搏频率呈负相关(r=-0.82,P<0.01)。血镁浓度增加≥0.7mg/dl的患者,室性早搏频率下降(309±241)次/h,而增加<0.7mg/dl的患者,室性早搏频率是多变的。滴注前平均室性早搏频率为(405±366)次/h,滴注后为(214±165)次/h(P<0.01)。滴注前室性早搏频率<220次/h的患者,滴注后室性早搏频率无明显改变,分别为(126±45)次/h及(120±113)次/h,P>0.05。结论静脉滴注硫酸镁对于心力衰竭伴有频发室性早搏患者有明显降低室性早搏频率的作用,其机制与血清镁浓度快速增加有关。
Objective To investigate the therapeutic effect of intravenous infusion of magnesium sulfate on ventricular premature beats in patients with heart failure. Methods Thirty-two patients with chronic congestive heart failure with serum magnesium ≤1.9 mg / dl and ventricular premature beat> 10 times / h were given intravenous drip of magnesium sulfate (0.2 mEq / kg). The changes of serum magnesium concentration before and after dripping 6h Holter recorded precocious pacing frequency changes. Results The serum magnesium concentration was negatively correlated with the frequency of ventricular premature beat (r = -0.82, P <0.01). The frequency of ventricular premature beat decreased (309 ± 241) times / h in patients with an increase in serum magnesium concentration ≥ 0.7 mg / dl, whereas the frequency of ventricular premature beat was variable in patients with an increase of <0.7 mg / dl. Mean premature ventricular premature beats were (405 ± 366) / h before drip and (214 ± 165) times / h after drip (P <0.01). The frequency of premature ventricular contractions <220 beats / h before instillation did not change significantly (P <0.05). Conclusion Intravenous infusion of magnesium sulfate significantly attenuates the frequency of premature ventricular contractions in patients with congestive heart failure and frequent premature ventricular contractions, and its mechanism is related to the rapid increase of serum magnesium concentration.