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关键词：心力衰竭,充血性；洋地黄；洋地黄中毒
摘 要：目的 评价维持量地高辛间歇疗法治疗窦性心律心力衰竭的临床疗效。方法 113例窦性心律心力衰竭患者随机分为二组：A组：56例采用间歇维持量地高辛治疗；B组57例采用持续维持量地高辛治疗。结果 两组患者治疗前与治疗3个月和8个月比较左心室射血分数(LVEF，A组分别为0.36±0.12,0.42±0.11, 0.44±0.14；B组分别为0.36±0.15, 0.43±0.13, 0.45±0.15)，心室率(HR，次/min，A组分别为98±15, 76±16, 74±14；B组分别为100±12,75±12, 75±16)治疗后与治疗前比较差异均有显著性(P<0.01)，二组间比较差异无显著性(P>0.05)；地高辛过量或中毒的发生率两组差异有显著性(P<0.01)。结论 间歇维持量地高辛疗法可降低洋地黄过量或中毒的发生率，其疗效相似，可能是一种安全有效的临床给药方法。
Clinicalevaluation of intermittent maintenance digoxin therapy in congestive heart failure withsinus rhythm
CAI Shanglang ZHENG Xiaoyun LU Zhuoren, et al.
( Department ofCardiology, Affiliated Hospital of Qingdao Medical College, Qingdao 266003, China )
Abstract ： Objective To study the effects ofintermittent maintenance digoxin therapy in congestive heart failure with sinus rhythm. Methods One hundred and thirteencongestive heart failure patients with sinus rhythm divided into group A (56 cases withintermittent maintenance digoxin treatment) and group B (57 cases with continuousmaintenance digoxin treatment) were observed for 8 months. Results As compared with the pretreatmentdata, left ventricular ejection fraction (LVEF) and heart rate (HR) (LVEF 0.36±0.12 vs0.42±0.11 and 0.44±0.14 in group A, 0.36±0.15 vs 0.43±0.13 and 0.45±0.15 in group B;HR 98±15 vs 76±16 and 74±14 in group A, 100 ±12 vs 75±12 and 75±16 in group B,respectively) were significantly improved (P<0.01) at the 3rd and 8th month oftreatment. The total occurrence rate of digoxin overload or toxication in group A wassignificantly lower than those in group B (3.6% vs 12.3%, respectively (P<0.01). Conclusion Intermittent maintenance digoxintreatment in congestive heart failure with sinus rhythm is effective and safe, with alower digitalis toxication occurrence compared with continuous maintenance digoxintreatment.
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