(洋地黄中毒:specifity和心脏和extracardiac症状的重要性。第一部分:digitalis-induced患者心律失常(作者transl)]。
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林根W,康尼锡E, Sturm W
(洋地黄中毒:specifity和心脏和extracardiac症状的重要性。第一部分:digitalis-induced患者心律失常(作者transl)]。
Z Kardiol。1977年3月,66 (3):121 - 8。
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857452年(在PubMed]
- 文摘
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1164例临床和electrocardiographical结果与血清地高辛浓度(署)。洋地黄中毒的诊断是基于节奏干扰消失在withdrawel的药物。均值署digitalis-induced患者心律失常是3.07 ng / ml相比1.02 ng / ml患者正常患者的心电图和1.01 ng / ml节奏干扰其他的起源。以2.0 ng / ml为洋地黄中毒的下限85%以上巧合被发现之间的基于串行心电图的诊断和发展水平。没有心脏毒性的迹象被发现患者署小于1.6 ng / ml,一些病人,然而,显示正常心电图的尽管署4.5 ng / ml。提交大于1.9 ng / ml的患者和正常心电图明显小于digitalis-induced患者心律失常的可比署。尽管没有明确的诊断心脏毒性可能是成立于327年的情况下,患者的临床资料提交2.0 ng / ml的密切和更大的像那些digitalis-induced心律失常而提交小于2.0 ng / ml的患者显示患者密切的相似之处没有心脏毒性方面的证据:平均年龄、肾功能,平均地高辛剂量和平均体重。提交了45%的发病率升高患者肾功能严重受损与28%的患者署小于2.0 ng / ml。即使在肾功能正常的患者口服地高辛剂量之间的关系和发展水平较差。显著的相关性更好的dogoxin管理时静脉注射。 Therefore knowing the amount of digoxin taken (according to the patient's statement) seems of little benefit in the evaluation of digitalis toxicity. In patients with digitalis-induced arrhythmias mean age and mean body weight were significantly lower, mean creatinine concentration and the incidence of severe cardiac insufficency and of typical ST-T-changes were significantly higher. There was no significant difference in mean potassium concentration and incidence of coronary artery disease compared to nontoxic patients. Compared to patients with cardiac arrhythmias of other origin there were no significant differences in mean age, mean potassium and creatinine concentrations and cardiac insufficiency while the incidence of coronary artery disease was significantly higher among patients with rhythm disturbances of other origin. Every type of rhythm disturbance can be digitalis-induced. Among our patients the incidence of digitalis-induced second-degree atrioventricular block (Wenckebach), ventricular bigeminy, nonparoxysmal nodal tachycardia and PAT with block was significantly higher while patients with rhythm disturbances of other origin showed an equally high incidence of PVB's and prolongation of PQ interval...
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