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目的探讨地尔硫卓对难治性不稳定心绞痛的疗效和安全性。方法38例对常规抗心绞痛和抗栓治疗无效的不稳定心绞痛患者,停用硝酸酯和美托洛尔,改用静脉持续泵入地尔硫卓72h治疗。控制逐渐滴定地尔硫卓的剂量。观察治疗前后心绞痛发作、发作时ST段压低及血流动力学指标的变化,并注意药物不良反应。结果地尔硫卓治疗后,心绞痛得到有效控制,总有效率92.1%。与治疗前比较,治疗后的平均心绞痛发作次数、每次发作持续时间、发作时ST段压均明显降低(均P<0.01);治疗后24、48和72h的血压、心率(均P<0.05)和收缩压×心率均明显降低(P<0.01),未发现严重不良反应。结论地尔硫卓静脉泵入治疗难治性心绞痛安全、有效,但需严格控制滴定药物剂量。
Objective To investigate the efficacy and safety of diltiazem in refractory unstable angina pectoris. Methods Thirty - eight patients with unstable angina pectoris who had no effect on conventional anti - angina pectoris and antithrombotic therapy were discontinued nitric ester and metoprolol, and were treated with intravenous continuous infusion of diltiazem for 72 hours. Control titration of diltiazem. Before and after treatment to observe the onset of angina pectoris, ST segment depression and hemodynamic changes, and pay attention to adverse drug reactions. Results After diltiazem treatment, angina pectoris was effectively controlled, with a total effective rate of 92.1%. Compared with those before treatment, the average number of angina attacks, the duration of each episode and the ST segment pressure at the time of attack were significantly decreased (all P <0.01); the blood pressure and heart rate at 24, 48 and 72 hours after treatment ) And systolic blood pressure × heart rate were significantly lower (P <0.01), no serious adverse reactions were found. Conclusion Diltiazemium intravenous infusion is safe and effective in the treatment of refractory angina pectoris, but the dose of titration drug should be strictly controlled.