Kochmański M, Zochowski R J
Kliniki Kardiologii Instytutu Medycyny Klinicznej MSW.
Pol Arch Med Wewn. 1990 Nov;84(5):309-20.
21 patients with symptoms of chronic congestive heart failure, NYHA classes II-IV, were treated with digoxin and furosemide for at least 14 days. In the next stage of the therapy they additionally received a 200 mg intravenous dosage of pentoxifylline and continued to take pentoxifylline orally for the period of at least 14 days. Before the therapy and after each of its stages echocardiography was performed, rheological and gasometric indices of the blood were determined and the level of physical efficiency was assayed in each patient according to NYHA classification. After the digoxin-furosemide treatment there was a significant increase in viscosity of the blood caused by its condensation. Simultaneously there could be observed a significant increase in physical efficiency in patients and also an improvement in some of indices of the left ventricular functions and in gasometric characteristics of the blood. Due to intravenous administration of pentoxifylline a decrease in blood viscosity occurred. The combined treatment with orally administered digoxin, furosemide and pentoxifylline caused a further decrease of blood viscosity, an improvement in some indices of left ventricular efficiency and gasometric characteristics of blood and also much better physical condition of the patients. The results of the present study show that in chronic congestive heart failure subjects a digoxin-furosemide treatment, besides undoubtedly advantageous haemodynamic effects, also leads to blood viscosity. The addition of pentoxifylline results the reduction of increased blood viscosity and in much better hemodynamic condition of the patients.
21例纽约心脏协会（NYHA）心功能II - IV级的慢性充血性心力衰竭患者接受了地高辛和呋塞米治疗至少14天。在治疗的下一阶段，他们额外接受了200毫克静脉注射剂量的己酮可可碱，并继续口服己酮可可碱至少14天。在治疗前及每个治疗阶段后，均进行超声心动图检查，测定血液的流变学和气体测量指标，并根据NYHA分级对每位患者的体力效率水平进行评估。地高辛 - 呋塞米治疗后，血液因浓缩而导致的粘度显著增加。同时，可观察到患者的体力效率显著提高，左心室功能的一些指标以及血液的气体测量特征也有所改善。由于静脉注射己酮可可碱，血液粘度降低。地高辛、呋塞米和己酮可可碱联合口服治疗导致血液粘度进一步降低，左心室效率和血液气体测量特征的一些指标得到改善，患者的身体状况也更好。本研究结果表明，在慢性充血性心力衰竭患者中，地高辛 - 呋塞米治疗除了具有无疑有益的血流动力学效应外，还会导致血液粘度增加。添加己酮可可碱可降低升高的血液粘度，并使患者的血流动力学状况更好。
