电邮这篇文章 心脏药物过量医院登记试点（HRCDO）的结果：主要是药物介导的心动过缓
- 作者: Yakushin S.S.1, Nikulina N.N.1, Filippov E.V.1, Seleznev S.V.1, Lygina E.V.1, Chernysheva M.B.1
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隶属关系:
- Ryazan State Medical University
- 期: 卷 28, 编号 2 (2020)
- 页面: 153-163
- 栏目: Original study
- URL: https://bakhtiniada.ru/pavlovj/article/view/34904
- DOI: https://doi.org/10.23888/PAVLOVJ2020282153-163
- ID: 34904
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详细
目的：分析了药物介导性心动过缓（DMB）作为一个医学和社会问题的相关性，其主要规律及确定了该问题的进一步研究必要性。
材料与方法：注册研究2017年1月1日至2018年6月3日（18个月）在Regional Clinical Cardiology Dispensary梁赞地区国家预算机构进行。纳入标准：1）在服用至少一种具有心动过缓作用（BCA）的药物制剂（MP）的同时出现心动过缓律失常综合征；2）签署知情同意书。在对登记在案的患者进行诊断或治疗时，没有进行额外的干预。
结果：18个月后，191例患者住院（年龄为77.0[69.0;82.0]岁，26.7%男生）在所有因用药过量而住院的病人中，有52.6%的人被证实患有药物性心动过缓。在分析期间，由于过量使用心脏病药物（1.7倍，p <0.001），特别是心动过缓作用药物（1.8倍，p <0.001），住院人数有所增加。药物引起的心动过缓的主要临床表现：降低心率（< 50次/分钟—80.0%，< 40次/分钟—51.1%）、窦房结（30.4%）和房室的（1型—8.2%，2型—10.4%，3型—14.1%）封锁，晕厥（32.6%），心脏停顿> 3秒（7.4%）。94.8%的患者住院接受紧急护理，40.7%在麻醉科接受复苏；17.8%的病例需要植入起搏器；医院死亡率为5.2%。超过半数（54.5%）的住院患者服用2种以上的药物具有心动过缓的作用，15.7%的患者服用3种以上的药物，3.14%的患者服用4种以上的药物（单一疗法和联合用药）受体阻滞剂—68.4%，抗心律失常药物—38.9%，地高辛—25.8%，非二氢吡啶钙拮抗剂—10.5%，l1-咪唑啉受体激动剂—9.5%，其他心动过缓药物—7.4%。为分析药物性心动过缓的原因，我们收集了135例患者的临床资料（年龄为77.0岁[69.0;82.0]，20.7%男生），其能准确说出有心动过缓作用的药物的剂量。其中，有14.1%的病例记录了绝对超过推荐剂量的情况，有85.9%的病例记录了几种具有心慢效应的药物的效应总和/增强情况，每种药物都以治疗剂量服用。
结论。该研究证实了药物性心动过缓问题的高度医学和社会意义，这需要实际医生、药理学家和临床药理学家以及医疗保健组织者的关注，并继续其研究。
作者简介
Sergey Yakushin
Ryazan State Medical University
Email: maria-kiryukhina@mail.ru
ORCID iD: 0000-0002-1394-3791
SPIN 代码: 7726-7198
Researcher ID: A-9290-2017
MD, PhD, Professor, Head of the Department of Hospital Therapy with a Medical and Social Expertise Course
Natal`ya Nikulina
Ryazan State Medical University
Email: maria-kiryukhina@mail.ru
ORCID iD: 0000-0001-8593-3173
SPIN 代码: 9486-1801
Researcher ID: A-8594-2017
MD, PhD, Associate Professor, Professor of the Department of Hospital Therapy with a Medical and Social Expertise Course
俄罗斯联邦, RyazanEvgenii Filippov
Ryazan State Medical University
Email: maria-kiryukhina@mail.ru
ORCID iD: 0000-0002-7688-7176
SPIN 代码: 2809-2781
Researcher ID: O-1490-2016
MD, PhD, Associate Professor, Head of the Department of Outpatient Therapy and Preventive Medicine
俄罗斯联邦, RyazanSergey Seleznev
Ryazan State Medical University
Email: maria-kiryukhina@mail.ru
ORCID iD: 0000-0002-4069-8082
SPIN 代码: 4532-5622
Researcher ID: C-8725-2017
MD, PhD, Associate Professor of the Department of Hospital Therapy with a Medical and Social Expertise Course
俄罗斯联邦, RyazanElena Lygina
Ryazan State Medical University
Email: maria-kiryukhina@mail.ru
ORCID iD: 0000-0001-6746-6743
SPIN 代码: 9655-8070
Researcher ID: T-2974-2017
MD, PhD, Associate Professor of the Department of Hospital Therapy with a Medical and Social Expertise Course
俄罗斯联邦, RyazanMariya Chernysheva
Ryazan State Medical University
编辑信件的主要联系方式.
Email: maria-kiryukhina@mail.ru
ORCID iD: 0000-0002-5460-5027
Сlinical Resident of the Department of Hospital Therapy with a Medical and Social Expertise Course
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