血管扩张剂对心衰疗效良好,目前已作为心衰治疗的第三类药物(强心、利尿药为一、二类)。酚妥拉明和硝普钠仅能注射使用,因而有很大局限性。舌下含用硝酸甘油虽然方便,但作用时间较短。本文报告舌下含用二硝酸异山梨醇(ID)对急性肺水肿、顽固性心衰、慢性心衰患者的疗效观察。 7例急性肺水肿患者(第一组),均有典型急性发作表现:严重呼吸困难、端坐呼吸、舒张早期奔马律、两肺湿啰音、肺水肿X线表现。其中5例仅接受鼻管吸氧及舌下含用10毫克ID,2例在应用ID前曾接受速尿治疗无效。3例在应用ID前后分别进行临床和血液动力学测定。 5例顽固性心衰患者(第二组),平均年龄70岁,均在常规强心、利尿药剂量治疗后仍表现明显左心 Vasodilators have a good effect on heart failure, and are currently the third category of drugs for heart failure (cardiac, diuretic for one and two). Phentolamine and sodium nitroprusside can only be injected, and therefore has great limitations. Sublingual nitroglycerin although convenient, but the role of time is shorter. This article reports the efficacy of sublingual inositol dinitrate (ID) on patients with acute pulmonary edema, refractory heart failure, and chronic heart failure. Seven patients with acute pulmonary edema (group 1) had typical acute exacerbations: severe dyspnea, sitting breathing, early gallop, gall bladder auscultation and pulmonary edema. Five of these patients received only nasal oxygen inhalation and sublingual 10 mg of ID, and two received ineffective furosemide treatment prior to the application of ID. Three patients had clinical and hemodynamic determinations before and after application ID. 5 patients with refractory heart failure (second group), mean age 70 years, were in conventional cardiac, diuretic dose after treatment still showed significant left heart