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作者研究了10例急性心肌梗死合併左心衰竭患者应用长效血管扩张药二硝酸异山梨醇脂的血液动力学作用。10例(男9例、女1例)的平均年龄62(±9)岁,均收进冠心病监护室进行研究。其诊断根据典型病史,心电图出现新的Q波和心脏酶的改变。梗死的6例为前壁,3例为后壁,和1例左束支传导阻滞。2例过去有心肌梗死病史。所有患者均有左心衰竭的临床表现,7例有第三或第四心音,大多数患者肺底可听到捻髪音,9例有肺水肿的X线改变。结果 10例在对照期平均肺动脉楔压均升高>12毫米汞柱,舌下含服二硝酸异山梨醇脂5毫克10分钟后平均肺动脉楔压降低35％,从20±6毫米汞柱下降
The authors studied the hemodynamic effects of long-acting vasodilator Isosorbide dinitrate in 10 patients with acute myocardial infarction and left ventricular failure. Ten patients (9 males and 1 females) with an average age of 62 (± 9) years were enrolled in the coronary care unit for study. The diagnosis based on the typical history, ECG Q wave and new changes in cardiac enzymes. Six of the infarcts were anterior, three posterior, and a left bundle branch block. 2 cases of past history of myocardial infarction. All patients had clinical manifestations of left heart failure, 7 patients had a third or fourth heart sound, most patients could hear twisting sound in the bottom of the lung, and 9 patients had X-ray of pulmonary edema. Results The average pulmonary artery wedge pressure was increased> 12 mmHg in the control group, and the average pulmonary artery wedge pressure was reduced by 35% from 5 mg of isosorbide dinitrate subconjunctival 10 minutes after the control period, from 20 ± 6 mmHg