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地高辛的正性肌力作用广泛用于治疗充血性心力衰竭,但平均心脏指数(CI)仅增加18%;儿茶酚胺与地高辛并用CI增加33%,但继续应用儿茶酚胺同引起心肌纤维变性、局部脂质聚积和心内膜下出血.动物实验证明,地高辛对心肌除有直接的正性肌力作用外,还有胆碱能神经介导的负性肌力作用.作者试图以阿托品阻断地高辛的胆碱能效应,进一步增强心肌收缩力,增加心脏输出量(CO). 方法:10例男性病人,平均54岁,8例进行冠状动脉搭桥术,2例进行瓣膜置换术.2例术前巳接受维持量地高辛治疗;8例术后接受快速地高辛
Digoxin positive inotropic effect is widely used in the treatment of congestive heart failure, but the average cardiac index (CI) increased by only 18%; catecholamine and digoxin use CI increased by 33%, but continue to use catecholamines with myocardial fibrosis , Local lipid accumulation and subendocardial hemorrhage.Experimental studies have shown that digoxin on the myocardium in addition to a direct positive inotropic effect, there are cholinergic nerve-mediated negative inotropic effect. The author attempts to Atropine blocks the cholinergic effect of digoxin and further enhances myocardial contractility and increases cardiac output (CO) .Methods: 10 male patients, average 54 years old, 8 patients underwent coronary artery bypass graft and 2 patients underwent valve replacement Two patients had received maintenance dose of digoxin before surgery. Eight patients underwent rapid digoxin