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我们采用小剂量前列腺素E_1(PGE_1)治疗充血性心力衰竭患者25例,其中男17例、女8例,年龄18～82岁,平均60.6岁。有风湿性瓣膜病,高血压心脏病,充血性心肌病,冠心病。心功能Ⅲ级17例,Ⅳ级8例。用PGE_1300μg 加10%葡萄糖250ml,静滴4小时,相当于0.02μg/kg.min,每日一次,三天为一疗程。观察用药前及疗程结束后当天症状体征。部份复查胸片,M 型超声心动图,并检测肺毛细血管嵌入压(PCW),免疫球蛋白和花环试验。结果疗程后绝大多数患者症状及体征明显改善。心悸、胸闷、气急消失占25～31%,减轻占63～75%,肺罗音消失、减轻占75%,下肢浮肿消失、减轻占91.6%。心率平均减少9.5次/分(P<0.05)。收缩压平均降低10.2mmHg,舒张压平均降低6.8mmHg。不能平卧20例中,11例已能平卧,6例能间断平卧或高枕卧位,3例无变化。记录耐力变化22例,除4例外,18(81%)例均有不同程度增加。
We used a small dose of prostaglandin E_1 (PGE_1) in patients with congestive heart failure in 25 cases, including 17 males and 8 females, aged 18 to 82 years, mean 60.6 years. Rheumatic valvular disease, hypertensive heart disease, congestive cardiomyopathy, coronary heart disease. Heart function Ⅲ grade in 17 cases, Ⅳ grade in 8 cases. With PGE_1300μg plus 10% glucose 250ml, intravenous infusion of 4 hours, equivalent to 0.02μg / kg.min, once daily, three days for a course of treatment. Observed before treatment and after the end of treatment symptoms and signs. Part of the review chest X-ray, M-mode echocardiography, and pulmonary capillary embedding pressure (PCW), immunoglobulin and rosette test. Results After treatment, the symptoms and signs of the vast majority of patients improved significantly. Palpitations, chest tightness, shortness of breath accounted for 25 ~ 31%, reduce 63 ~ 75%, lung rales disappeared, reduce 75%, lower extremity edema disappeared, reduce 91.6%. Heart rate decreased by an average of 9.5 beats / min (P <0.05). Systolic blood pressure decreased by an average of 10.2mmHg, diastolic blood pressure decreased by an average of 6.8mmHg. Can not supine in 20 cases, 11 cases have supine, 6 cases can be supine or high supine position, 3 cases no change. 22 cases of endurance changes were recorded, with the exception of 4 cases, 18 (81%) cases were increased to varying degrees.