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在特发性QT延长综合征、心率缓慢、使用抗心律失常药、电解质紊乱时可发生尖端扭转型室速(TDP),常规用异丙基肾上腺素和快速心脏刺激治疗,目的是增加心率缩短不应期。但在缺血性心脏病和高血压病人,二者都是不利的,且心脏起搏常不能很快施行。而硫硫酸镁(MgSO_4)在常多室性心律失许中已证明是有用的。它可能成为治疗TDP有效的另一种疗法。作者用硫酸镁治疗6例TDP患者,以生理盐水稀释快速输注(50毫克/分)。所有病例均在20-30分钟内消失,继继2小时以同样速度输入,以后3-4天,2次/天,每次90分钟,以30毫克/分的速度输注。无副反应,心率和QTc间期均无改变。(6例发作时,窦律期间QTc均延长,分别为580、635、500、580、560、620毫秒)。
In idiopathic QT prolongation syndrome, the heart rate is slow, the use of anti-arrhythmic drugs, electrolyte imbalance can occur when the torsades de pointes (TDP), conventional isoproterenol and rapid cardiac stimulation therapy, the purpose is to increase heart rate shortened Should not be. However, in both ischemic heart disease and hypertensive patients, both are unfavorable and cardiac pacing can often not be performed quickly. Magnesium sulphate (MgSO4), however, has proven to be useful in the management of ventricular arrhythmias. It may be another therapy for the effective treatment of TDP. The authors treated six patients with TDP with magnesium sulfate, bolus diluted with saline (50 mg / min). All cases disappeared in 20-30 minutes, followed by 2 hours at the same speed input, after 3-4 days, 2 times / day, each 90 minutes, at a rate of 30 mg / min infusion. No side effects, heart rate and QTc interval were unchanged. (6 cases of seizures, QTc during sinus rhythm were extended, respectively 580,635,500,580,560,620 milliseconds).