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目的比较地高辛单用及与地尔硫联用对心衰合并慢性房颤患者静息时及运动后心室率控制的效果。方法充血性心衰合并慢性房颤患者共60例,分为A、B两组,各30例。两组在治疗前两周均未用过地尔硫,原有用地高辛者应停用两周后入选治疗。A组:应用地高辛0.25 mg,Bid,口服,连服3天,第4天开始改为0.25 mg,qd晨服维持,疗程1个月;同时联用盐酸地尔硫缓释胶囊,90 mg,qd,疗程同上。B组:单用地高辛,其用量、用法及疗程与A组相同。结果A、B两组治疗前后自身比较,不论静息时或是运动后心室率均有明显减慢(P<0.001),而组间比较,A组显著优于B组(P<0.001)。两组治疗后不论收缩压或是舒张压均有轻度下降,但无统计学意义(P>0.1~0.2),说明地尔硫对正常血压无明显影响。结论地高辛与地尔硫联用组对心衰合并慢性房颤的心室率控制效果显著优于地高辛单用组,值得临床推广应用。
Objective To compare the effects of digoxin alone and in combination with diltiazem on resting and post-exercise ventricular rate control in patients with heart failure and chronic atrial fibrillation. Methods A total of 60 patients with congestive heart failure and chronic atrial fibrillation were divided into A and B groups, 30 cases in each. Two groups in the first two weeks before treatment did not use diltiazem, the original digoxin should be discontinued two weeks after the treatment was selected. Group A: digoxin 0.25 mg, Bid, orally, and even served 3 days, the first 4 days to 0.25 mg, qd morning service to maintain a course of 1 month; at the same time diltiazem hydrochloride hydrochloride sustained release capsules, 90 mg, qd, treatment as above. Group B: digoxin alone, its dosage, usage and treatment with the same group. Results Before and after treatment, the A and B groups both showed significant slowdown (P <0.001), both at rest and after exercise. The scores in group A were significantly better than those in group B (P <0.001). No significant difference in systolic blood pressure or diastolic blood pressure was found between the two groups (P> 0.1-0.2), indicating that diltiazem had no significant effect on normotensive blood pressure. Conclusion The combined effect of digoxin and diltiazem on ventricular rate in patients with heart failure and chronic atrial fibrillation is significantly better than that of digoxin alone, which is worthy of clinical application.