稳心颗粒联合比索洛尔治疗心力衰竭合并室性早搏疗效观察和安全性评价

目的观察稳心颗粒联合比索洛尔治疗心力衰竭合并室性早搏患者的临床疗效及其安全性。方法选择心功能Ⅱ～Ⅳ级的心力衰竭合并室性心律失常患者128例,分为A组,即稳心颗粒联合比索洛尔治疗组66例,给予步长稳心颗粒9g,3次/d,同时给予比索洛尔2.5～10mg,1次/d;B组62例,单用比索洛尔2.5～10mg,1次/d。4周为1疗程,比较治疗前后临床症状、24h动态心电图的变化、对心功能影响、药物致心律失常作用及不良反应。结果①治疗前后A组临床症状改善上效果优于B组(P<0.01);②治疗前后两组室性早搏次数间差异有统计学意义(A组:P<0.01;B组:P<0.05),但A组效果明显优于B组,治疗前后两组PR间期及QTC间期差异无统计学意义(P>0.05);③治疗前后两组间左室射血分数差异无统计学意义。结论稳心颗粒联合比索洛尔对心力衰竭合并室性早搏患者近期疗效肯定,患者耐受性好、未见致心律失常作用,且比较安全,无明显副作用,具有临床应用价值。     

稳心颗粒治疗老年糖尿病患者心律失常的临床观察

目的探讨稳心颗粒治疗老年糖尿病患者心律失常的临床疗效及安全性。方法将76例老年糖尿病心律失常患者随机分为治疗组和对照组，分别给予口服稳心颗粒，9g／次，3次／d，心律平片，100mg／次，3次／d，4周为1个疗程。结果稳心颗粒组和心律平组的治疗总有效率差异无统计学意义（P〉0．05），均对早搏治疗效果良好，但治疗组症状改善情况好于对照组（P〈0．05）两组患者前后对血糖均无明显影响。结论稳心颗粒对治疗老年糖尿病患者心律失常疗效显著，安全有效。     

步长稳心颗粒治疗心律失常的疗效观察

目的观察步长稳心颗粒(简称为稳心颗粒)治疗心律失常的疗效及安全性。方法 204例频发室早患者,室上性早搏98例,室性早搏106例,在常规治疗基础上给予稳心颗粒,2包/次,3次/日,儿童酌情减量,4周为1个疗程。用药前、1周及4周分别记录24h动态心电图,评价患者一般状态、早搏次数、心率、P-R间期、Q-T间期,对于治疗一周无效者改服心律平150mg/日,3次/日,前后对照,观察治疗前后24h动态心电图变化。结果稳心颗粒可以明显缓解心悸等临床症状,服药1周时对早搏的显效率为22.8%(室上性20.4%,室性25.0%),总有效率为54.0%(室上性44.9%,室性62.5%),治疗4周显效率为30.2%(室上性31.7%,室性28.2%),总有效率为78.6%(室上性73.2%,室性84.6%),该药对心率、PR间期、最大QT间期、最大QTc间期无明显影响(P>0.05)。除2例患者因过敏(皮肤出现红疹,瘙痒)停药外,其余未发现不良反应。结论稳心颗粒对心律失常疗效确切,不良反应少。     

稳心颗粒对稳定型心绞痛QT间期离散度的影响

目的通过分析稳心颗粒治疗稳定型心绞痛患者前后QT间期(QTd)离散度的变化,评价稳心颗粒对改善QTd的意义。方法选择30例稳定型心绞通患者,口服稳心颗粒每次1袋(9g),3次/d,疗程4周,治疗前后测患者体表心电图QTd的变化。结果治疗前后QTd有明显下降,差异显著。结论稳心颗粒能显著改善稳定型心绞痛QTd,提示可起到减少恶性心律失常发生的作用。     

稳心颗粒治疗室性期前收缩临床观察

目的观察稳心颗粒治疗室性期前收缩的疗效及安全性。方法76例患者在常规治疗的基础上,停用抗心律失常药物至少5个半衰期后,给予稳心颗粒治疗,每次1包(9g),3次/d,温开水冲服,4周为1个疗程。结果服用稳心颗粒4周后,85.52%的患者症状明显改善,实验室检查及HP、PR间期、QRS时限,QT间期与用药前比较差异无统计学意义(P>0.05)。对全部室性期前收缩总有效率达85.52%,与治疗前比较差异有统计学意义(P<0.01),其中31例功能性室性期前收缩总有效率达93.54%。结论稳心颗粒对于治疗室性期前收缩,尤其是功能性室性期前收缩治疗显著,且无明显不良反应。     

稳心颗粒治疗早搏的临床观察

目的观察步长稳心颗粒治疗早搏的疗效及安全性。方法将81例早搏患者随机分为治疗组和对照组,治疗组患者口服步长稳心颗粒(山东步长制药有限公司生产),每次9g,3次/d。对照组口服心律平片,每次100mg,1日3次,疗程均为4周。结果治疗组治疗前后24小时动态心电图监测早搏次数明显减少,差异有统计学意义(P<0·001),疗效与对照组相当。结论步长稳心颗粒治疗早搏安全有效。     

稳心颗粒与丹红注射液联合治疗冠心病合并心律失常的疗效观察

目的观察稳心颗粒与丹红注射液联合治疗冠心病合并心律失常的疗效。方法将210例患者随分为稳心颗粒联合丹红注射液组(治疗组)和胺碘酮组(对照组),观察治疗前后心律失常数-早搏、心肌缺血、药物不良反应。结果两组治疗前后心律失常程度明显改善(P<0.01),治疗前后心电图中ST段下降幅度得以明显改善(P<0.05),但治疗组优于对照组(P<0.05)。结论稳心颗粒与丹红注射液联合治疗冠心病合并心律失常疗效显著,安全性好,无明显毒副作用,药物依从性良好,值得临床上推广。     

步长稳心颗粒治疗甲亢性心动过速的疗效观察

目的观察步长稳心颗粒治甲亢性心动过速的临床疗效和不良反应。方法将66例甲亢性心动过速患者随机分为2组,治疗组34例,对照组32例,均予以常规的甲亢基础治疗(抗甲状腺药物治疗),治疗组34例在此基础上服用步长稳心颗粒,每次1包(9g),每日3次;对照组32例在常规治疗基础上服用倍他乐克片(美托洛尔),每次25mg,每日2次,疗程4周。4周后分别检查心电图,并观察临床疗效及不良反应。结果治疗组总有效率91·18%,对照组总有效率93·75%。两组治疗效果相当,无显著差异(P>0·05),治疗组无明显不良反应。结论步长稳心颗粒治疗甲亢性心动过速有较高的临床应用价值,副作用少,适应证范围广,值得临床推广。     

冠心病合并心律失常临床治疗观察80例

目的 总结评价冠心病合并心律失常患者的临床治疗药物的安全性和疗效.方法 选择入院后诊断为冠心病合并心律失常的患者80例,随机分为稳心颗粒组(治疗组)和胺碘酮组(对照组),用药时间1个月,观察治疗药物稳心颗粒对冠心病合并心律失常患者的临床疗效和不良反应.结果 两组药物对冠心病合并心律失常治疗前后比较无统计学差异(P>0.05).而且两组药物均能使患者期前收缩次数明显减少(P>0.01).结论 稳心颗粒治疗冠心病合并心律失常患者的疗效与胺碘酮相当,但是临床不良反应的发生比率明显低于胺碘酮,适合治疗各类心律失常.     

稳心颗粒联合胺碘酮治疗房颤合并频发室性心律失常的临床效果

目的分析房颤合并频发室性心律失常采用稳心颗粒联合胺碘酮治疗的临床效果。方法盲选收治的90例房颤合并频发室性心律失常患者,均分为两组,对照组45例采用胺碘酮药物治疗,观察组45例在胺碘酮治疗基础上结合采用稳心颗粒用药治疗,对比两种用药方法的治疗效果。结果观察组患者的症状治疗效果以及Holter疗效均无明显差异(P>0.05),但观察组患者的长间期发生情况明显少于对照组,差异有统计学意义(P<0.05)。结论房颤合并频发室性心律失常患者采用稳心颗粒联合胺碘酮用药治疗,可有效控制心律失常,应用安全可靠,值得应用推广到临床治疗中。     

稳心颗粒治疗窦性心动过缓合并室性早搏的临床观察

目的 观察稳心颗粒治疗窦性心动过缓合并室性早搏的疗效与安全性.方法 选择窦性心动过缓合并室性早搏患者60例,给予稳心颗粒9 g/次,3次/d口服,4周后复查心电图1次及24 h动态心电图(Holter).观察治疗前后室早次数、心率、临床症状改善情况及药物不良反应情况.结果 治疗后临床症状明显改善、早搏明显减少.结论稳心颗粒治疗窦性心动过缓合并室性早搏安全有效且无明显不良反应.     

Influence of exposure to electromagnetic field on the cardiovascular system

1 We examined whether extremely low frequency electromagnetic fields (ELF-EMF) affect the basal level of cardiovascular parameters and influence of drugs acting on the sympathetic nervous system. 2 Male rats were exposed to sham control and EMF (60 Hz, 20 G) for 1 (MF-1) or 5 days (MF-5). We evaluated the alterations of blood pressure (BP), pulse pressure (PP), heart rate (HR), and the PR interval, QRS interval and QT interval on the electrocardiogram and dysrhythmic ratio in basal level and dysrhythmia induced by beta-adrenoceptor agonists. 3 In terms of the basal levels, there were no statistically significant differences among control, MF-1 and MF-5 in PR interval, QRS interval, mean BP, HR and PP. However, the QT interval, representing ventricular repolarization, was significantly reduced by MF-1 (P < 0.05). 4 (-)-Dobutamine (beta1-adrenoceptor-selective agonist)-induced tachycardia was significantly suppressed by ELF-EMF exposure in MF-1 for the increase in HR (DeltaHR), the decrease in QRS interval (DeltaQRS) and the decrease in QT (DeltaQT) interval. Adrenaline (nonselective beta-receptor agonist)-induced dysrhythmia was also significantly suppressed by ELF-EMF in MF-1 for the number of missing beats, the dysrhythmic ratio, and the increase in BP and PP. 5 These results indicated that 1-day exposure to ELF-EMF (60 Hz, 20 G) could suppress the increase in HR by affecting ventricular repolarization and may have a down-regulatory effect on responses of the cardiovascular system induced by sympathetic agonists.     

戊巴比妥钠腹腔麻醉对C57BL/6J小鼠体表心电图的影响

目的 观察戊巴比妥钠腹腔内注射麻醉对小鼠体表心电图(ECG)指标,包括心率、PR间期、QRS波宽度和QT间期随麻醉时间延长的变化规律.方法 6只雄性C57BL/6J小鼠,腹腔内注射戊巴比妥钠75 mg·kg-1后,每10 min记录ECG一次,直至90 min,分析ECG各指标的变化规律.结果 所有6只小鼠均顺利完成实验.戊巴比妥钠腹腔内注射后10～60 min时随给药时间延长,测得的心率显著减慢[(353.0±31.3)、(287.5±34.8)、(234.9±38)、(207.9±37.3)、(190.8±32.9)和(175.8±25.5)次/分钟,P<0.01],QRS波宽度显著增宽[(11.3±0.5)、(12.3±0.5)、(13.3±0.7)、(13.9±0.8)、(14.1±0.9)和(14.3±1.0)ms,P<0.05],QT间期显著延长[(18.8±0.5)、(20.9±0.9)、(23.0±1.1)、(24.5±1.3)、(25.7±2.0)和(26.4±2.2)ms,P<0.05].给药后60～90 min内测得的心率、QRS波宽度及QT间期均随给药时间延长而改变轻微,趋于平稳.而PR间期在注射后10～90 min的相邻两个测量采集点比较,均随给药时间延长而显著延长.结论 戊巴比妥钠腹腔注射麻醉可致小鼠心率显著减慢,PR间期、QRS波宽度和QT间期等ECG指标随麻醉时间延长而明显延长,在研究心律失常模式动物心电学表型时应予以重视.     

Comparative cardiovascular safety of risperidone and olanzapine,based on electrocardiographic parameters and blood pressure: A prospective open label observational study

Objective:

To assess the cardiovascular safety of two commonly prescribed atypical antipsychotics risperidone (RSP) and olanzapine (OZP) in schizophrenic patients, using electrocardiography (ECG) and Blood Pressure (BP).

Materials and Methods:

This was a 10-week prospective open label, observational study, carried out in a newly diagnosed 64 schizophrenic patients receiving either RSP or OZP. RSP (n = 32) was started with dose of 2 mg/day and increased to 4 mg/day after 2 weeks, whereas OZP (n = 32) was started at a dose of 5 mg/day and was increased to 10 mg/day after 2 weeks. Heart rate (HR), ECG parameters (PR, RR, QRS, QT intervals and QTc and QTd) and BP (systolic and diastolic in supine and standing position) were recorded at baseline (before drug therapy)) and during follow-up visits at 2(I), 6(II) and 10(III) weeks.

Results:

In the RSP group, at II and III follow-ups, a significant increase in the HR (P = 0.018, P = 0.011 respectively) as well as in QTc (P = 0.025, P = 0.015, respectively) was observed when compared to the basal values. In the OZP group, diastolic BP was significantly decreased in standing position at II and III follow-ups (P = 0.045 and P = 0.024, respectively) compared to the basal values. When the two groups were compared with each other, no significant differences were observed in the changes of HR, PR, QRS, QT, RR, QT, QTd and SBP (supine and standing position); and DBP (supine position). However, DBP in standing position showed a significant decrease in the OZP group at II and III follow-up (P = 0.036 and P = 0.016, respectively) compared to the RSP group.

Conclusions:

Patients treated with OZP are at higher risk to develop postural hypotension as compared with RSP; hence RSP could be better tolerated by patients taking antihypertensive drugs as compared with OZP whereas OZP would have a safer cardiac profile.KEY WORDS: ECG changes, heart rate, olanzapine, QTc, QTd, risperidone     

左氧氟沙星对2型糖尿病合并感染患者的QTc间期影响*

目的：探讨左氧氟沙星治疗2型糖尿病合并感染时,对患者QTc（QT校正间期）的影响;并探求引起QTc变化的危险因素。方法：收集2015-2018年我院住院的2型糖尿病且有细菌性感染迹象给予左氧氟沙星治疗的患者一般资料、糖化血红蛋白、血糖、血脂、12导联心电图。共入选2型糖尿病合并细菌性感染病例182例,予治疗前及治疗7日后测定静息态心电图,计算QTc间期。结果与结论：在238例患者中,用药前有56例存在QTc间期延长,占比23.53%,在治疗后有94例存在QTc间期延长,占比39.49%,治疗后QTc间期延长发生率高于治疗前,两者存在统计学差异。治疗前平均QTc为0.41 s,治疗后平均QTc为0.43 s,整体延长4.87%,两者存在统计学差异。通过Logistic回归分析表明QTc间期延长与性别、年龄、是否合并糖尿病周围神经病变、糖化血红蛋白水平以及糖尿病病程相关,为糖尿病患者使用左氧氟沙星发生心律失常的危险因素。     

Study of cardiac repolarization in healthy volunteers performed with mizolastine, a new H1-receptor antagonist

AIMS: The occurrence of serious dysrhythmias, such as torsades de pointes, with terfenadine and astemizole had led to a reexamination of the potential effect of H1 antihistamines on cardiac repolarization. Mizolastine is a potent, selective, nonsedating peripherally acting H1-receptor antagonist which is registered for rhinitis and urticaria at a recommended dose of 10 mg once daily. The present study was carried out to investigate the effects of therapeutic and supratherapeutic doses of mizolastine, on ventricular repolarization in healthy volunteers. METHODS: Twenty-four healthy young volunteers participated in a double-blind, placebo-controlled, randomised study with three parallel groups. Each group consisted of 2 way cross-over 7 day treatment periods where mizolastine (10, 20 or 40 mg) and placebo were randomly administered. On day 1 and day 7, 12-lead ECG recordings were performed prior and 0.5, 1, 2, 3, 4, 6, 8, 12, 16, and 20 h after dosing and from day 2 to day 6, before dosing and 1, 2, 3, and 4 h after. RESULTS: Whatever the analysis used (raw data, changes from baseline, incidence of individual out-of-range values) no significant differences were observed at any dose level vs placebo, on any of ECG parameters (HR, PR, QRS, QT, and QTc). In particular, no effect of mizolastine vs placebo was shown on QT and QTc although 95% CIs were wide. The only subject who exhibited a QTc>/=450 ms received placebo for 7 days. CONCLUSIONS: This study found no evidence of an effect of mizolastine up to 40 mg (four times the therapeutic dose) on ventricular repolarization in healthy volunteers.     

左氧氟沙星对2型糖尿病合并感染患者的QTc间期影响*

目的:探讨左氧氟沙星治疗2型糖尿病合并感染时,对患者QTc(QT校正间期)的影响;并探求引起QTc变化的危险因素。方法:收集2015-2018年我院住院的2型糖尿病且有细菌性感染迹象给予左氧氟沙星治疗的患者一般资料、糖化血红蛋白、血糖、血脂、12导联心电图。共入选2型糖尿病合并细菌性感染病例182例,予治疗前及治疗7日后测定静息态心电图,计算QTc间期。结果与结论:在238例患者中,用药前有56例存在QTc间期延长,占比23.53%,在治疗后有94例存在QTc间期延长,占比39.49%,治疗后QTc间期延长发生率高于治疗前,两者存在统计学差异。治疗前平均QTc为0.41 s,治疗后平均QTc为0.43 s,整体延长4.87%,两者存在统计学差异。通过Logistic回归分析表明QTc间期延长与性别、年龄、是否合并糖尿病周围神经病变、糖化血红蛋白水平以及糖尿病病程相关,为糖尿病患者使用左氧氟沙星发生心律失常的危险因素。     

糖尿病合并低血糖症90例的临床治疗分析

目的对糖尿病合并低血糖症患者治疗的效果和主要措施进行研究分析。方法抽取90例糖尿病合并低血糖症患者,采用强化胰岛素方法进行治疗。结果患者治疗后空腹血糖和餐后血糖水平明显优于治疗前,差异有统计学意义(P<0.05)。结论应用胰岛素强化治疗对糖尿病合并低血糖症患者的临床效果非常明显。     

戴蒙开颗粒对比格犬和小鼠的一般药理学研究

目的 观察戴蒙开颗粒对麻醉犬心血管系统、呼吸系统,对小鼠神经系统的影响。方法 戊巴比妥钠麻醉犬,经十二指肠给予戴蒙开颗粒,记录给药前及给药后30、60、120、180、210、240 min舒张压（SBP）、收缩压（DBP）、平均动脉压（MBP）、心率（HR）、心电图（T波振幅,ST段偏移,PR间期,QRS时限和QT间期）、呼吸频率、呼吸深度的变化。采用灌胃给药,观察戴蒙开颗粒对小鼠阈下睡眠剂量戊巴比妥钠催眠作用、协调运动、一般行为和自发活动的影响。结果 戴蒙开颗粒低、中、高等不同剂量组的比格犬SBP、DBP、MBP、HR、PR间期,QRS时限、QT间期、T波、呼吸频率和呼吸深度等指标均未见明显变化,与对照组相比,P>0.05。戴蒙开颗粒高剂量组和阳性对照组的翻正反射消失率均极显著性的升高（P<0.01）;各剂量、各时间点小鼠协调运动障碍的评级与阴性组比较均无显著性差异（P>0.05）;戴蒙开颗粒低剂量组在给药后90 min自发活动数显著性地降低（P<0.05）,戴蒙开颗粒高剂量组在给药后30、60、90 min自发活动数均极显著性地降低（P<0.01）。结论 戴蒙开颗粒对比格犬心血管系统、呼吸系统未见明显影响;戴蒙开颗粒中、低剂量对小鼠神经系统未见明显影响。     

瑞格列奈联合盐酸二甲双胍对2型糖尿病疗效的影响

目的 探讨瑞格列奈联合盐酸二甲双胍对2型糖尿病疗效的影响.方法 选择已确诊的初诊2型糖尿病患者120例,随机分观察组和对照组各60例.观察组给予瑞格列奈联合盐酸二甲双胍治疗,对照组给予盐酸二甲双胍治疗.观察两组治疗前后、1、2、4周时各项指标变化情况.结果 治疗前后两组的空腹血糖、餐后2 h血糖水平明显降低,差异有统计学意义(P<0.05);治疗后观察组的空腹血糖、餐后2 h血糖水平各项指标明显优于对照组,两组比较差异有统计学意义(P<0.05).结论 瑞格列奈联合盐酸二甲双胍治疗初诊2型糖尿病效果满意,优于单纯用药.