论文部分内容阅读
心律失常是临床常见的一组心血管病症状,病情差异很大,轻者不影响工作,重者可危及生命甚至猝死.虽然近年来抗心律失常药及治疗方法很多,但仍有一部分心律失常很顽固,临床处理很棘手.联合用药是根据抗心律失常药的电生理作用具有相加性和协同性这一假设而提出的,针对这一发生机制采用联合疗法,可获得成功,使各药单剂量及副作用减少.但是哪些药物可以联合是临床医生所关心的,本文结合临床实践及国内外文献综述如下.1 抗心律失常药物的分类目前抗心律失常药的分类,多采用Vaughawiliams分类法,按其电生理效应分四大类.1.1 第Ⅰ类 膜稳定剂,主要作用细胞膜,抑制钠通道,降低细胞膜对钠离子的通透性,从而减慢动作电位最大除极速度.此外尚能提高兴奋阈值,减慢传导速度及延长有效不应期.此类药物发展迅速,品种多,根据电生理作用的不同又分为三个亚类.①IA类:此类药物的主要作用是抑制钠通道.其代表药物有奎尼丁、普鲁卡
Arrhythmia is a common clinical symptoms of a group of cardiovascular disease, the condition varies greatly, the light does not affect the work, severe cases can be life-threatening or even sudden death .Although in recent years anti-arrhythmic drugs and treatment of many, but there are still some arrhythmias Very stubborn, clinical treatment is very difficult.Combination is based on the anti-arrhythmic drug electrophysiological effects of additive and synergistic hypothesis, and for this mechanism of combination therapy, can be successful, so that the various drugs Single dose and side effects decreased.However, which drugs can be associated with the clinicians are concerned, this article combines clinical practice and literature review at home and abroad are as follows.1 Classification of antiarrhythmic drugsAt present, the classification of antiarrhythmic drugs, more use Vaughawiliams classification, Divided into four categories according to their electrophysiological effects.1.1 The first class of membrane stabilizer, the main role of the cell membrane, inhibit sodium channels, reducing the permeability of sodium ions on the cell membrane, thereby slowing down the action potential maximum depolarization speed. Excitement threshold, slow down the conduction velocity and prolong the effective refractory period.These drugs develop rapidly, more varieties, according to the different electrophysiological role is divided into three Class .①IA categories: primary role of these drugs is to inhibit sodium channel representing drugs quinidine, procainamide.