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利多卡因是治疗室性快速性心律失常的首选药物。本文报道美国、加拿大等4个国家的9个医院的750例住院患者静脉应用该药的毒性反应及其诱发因素。患者平均64.8岁,40.1％为70岁以上老人。男性占62.1％,74％罹患心血管系统疾病,以急性心肌梗死(26.8％)、无急性心肌梗死的缺血性心脏病(16.7％)及心力衰竭(11％)等为主。77％的病人在入院后48小时内用药。部分患者同时服用了洋地黄(463例)、利尿剂(452例)、其他抗心律失常药(如奎尼丁、普鲁卡因酰胺、β受体阻滞剂等343例)、抗心绞痛的硝酸盐类(149例)、降压药物(52例)及肾上腺素能类制剂(103例)等。发生毒性反应者47例,发生率为6.3％。以中枢神经系统的功能紊乱(31例)和心血管反应(8例)最为多见,4例两者兼有。其中12例属危及生命的严重反应:中枢神经系统功能紊乱表现为嗜睡、呼吸抑制或昏迷者4例;癫痫大发作2例;心脏传导阻滞、
Lidocaine is the drug of choice for the treatment of ventricular tachyarrhythmia. This article reports the intravenous toxicity and evoked factors of 750 inpatients in nine hospitals in four countries including the United States and Canada. The average patient was 64.8 years and 40.1% were over 70 years old. 62.1% of men and 74% of patients with cardiovascular diseases were acute myocardial infarction (26.8%), ischemic heart disease without acute myocardial infarction (16.7%) and heart failure (11%). 77% of patients receive medication within 48 hours after admission. Some patients also took digitalis (463 cases), diuretics (452 cases), other antiarrhythmic drugs (such as quinidine, procainamide, β blockers and other 343 cases), anti-angina Nitrate (149 cases), antihypertensive drugs (52 cases) and adrenergic agents (103 cases). Toxicity in 47 cases, the incidence was 6.3%. In the central nervous system dysfunction (31 cases) and cardiovascular response (8 cases) most common, 4 cases both. Among them, 12 were serious life-threatening reactions: 4 cases showed drowsiness, respiratory depression or coma in central nervous system disorders, 2 cases with epileptic seizures, cardiac conduction block,