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以洋地黄类为代表的強心甙于1785年就开始在临床应用,长期以来是增強心肌收缩力的唯一药物,虽然60年代以后,已逐渐出现一些非強心甙的正性肌肉药物,但目前洋地黄类仍是治疗心力衰竭的主要药物,而且对它的认识和应用也有不少发展。 一、洋地黄类作用机理的进展 尽管洋地黄类的应用有近200年的历史,但其增強心肌收缩力的机理仍未完全阐明。近年的研究认为,洋地黄类的強心作用在于它增加Ca~(++)进入细胞,Ca~(++)与向宁蛋白(即肌钙蛋白),改变向宁蛋白和向肌凝蛋白的分子构象,促进肌凝蛋白和肌纤蛋白的结合而实
Cardiac glycosides, represented by digitalis, began to be used clinically in 1785 and have long been the only drug that enhances myocardial contractility. Although some positive muscle drugs of non-cardiac glycosides have gradually emerged since the 1960s, Rehmannia is still the main treatment of heart failure drugs, but also its understanding and application of a lot of development. First, the progress of the mechanism of action of digitalis Although the application of digitalis has nearly 200 years of history, but its mechanism to enhance myocardial contractility has not yet fully elucidated. Recent studies suggest that the cardiotonic effect of digitalis is that it increases Ca ~ (++) entry into cells, Ca ~ (++) and naringin (ie, troponin), changes to ninglingin and to myosin Molecular conformation to promote the combination of myosin and myofibrillar