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心律失常的电生理学与药理学。VIII. 苯妥英钠的心脏效应。B.

Electrophysiology and pharmacology of cardiac arrhythmias. VIII. Cardiac effects of diphenylhydantoin. B.

作者信息

Wit A L, Rosen M R, Hoffman B F

出版信息

Am Heart J. 1975 Sep;90(3):397-404. doi: 10.1016/0002-8703(75)90331-2.

Abstract

DPH is highly effective against both atrial and ventricular arrhythmias resulting from digitalis toxicity and should be considered one of the primary antiarrhythmic drugs in this clinical situation. Clinical studies have indicated that DPH, for the most part, is effective against atrial arrhythmias and not markedly effective against ventricular arrhythmias associated with acute or chronic cardiac disease. For the latter ventricular arrhythmias, DPH is usually considered only after other antiarrhythmic drug therapy has failed. Studies on the mechanisms responsible for the antiarrhythmic effects of DPH are, as yet, inconclusive, There is good evidence that its actions differ from those of the commonly used drugs with local anesthetic effects. The extent to which it exerts direct effects on the heart which are therapeutically relevant remains to be demonstrated; further, there is solid evidence that its effects on the central nervous system may be of prime importance in its antiarrhythmic efficacy.

摘要

双苯吡乙胺对洋地黄毒性所致的房性和室性心律失常均有高效,在这种临床情况下应被视为主要的抗心律失常药物之一。临床研究表明,双苯吡乙胺在很大程度上对房性心律失常有效,而对与急、慢性心脏病相关的室性心律失常效果不明显。对于后一种室性心律失常,通常只有在其他抗心律失常药物治疗无效后才考虑使用双苯吡乙胺。关于双苯吡乙胺抗心律失常作用机制的研究尚无定论,有充分证据表明其作用与常用的具有局部麻醉作用的药物不同。其对心脏产生治疗相关直接作用的程度仍有待证实;此外,有确凿证据表明其对中枢神经系统的作用在其抗心律失常疗效中可能至关重要。

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