Doherty J E, Kane J J, Phillips J R, Adamson J S
Drugs. 1977 Feb;13(2):142-51. doi: 10.2165/00003495-197713020-00004.
The use of digitalis in pulmonary heart disease has been a topic of great interest for a number of years. The physician's decision to use or not to use digitalis in pulmonary disease has often been an emotional rather than a reasoned one. The diagnostic difficulties from a clinical point of view in separation of pulmonary from cardiac symptoms and findings have also been confusing. The fact that small doses of digitalis may have an inotropic effect on the cardiac muscle has been a difficult concept for many physicians to adopt. On the other hand, the larger doses of digitalis that are often necessary to control the ventricular response in supraventricular arrhythmias sometimes gives rise to confusion. We shall attempt to review the subject in detail and examine indications, contraindications, toxicity, dosage, assessment of benefit, and role of digitalis serum levels in patient management.
多年来，洋地黄在肺心病中的应用一直是备受关注的话题。医生对于在肺部疾病中使用或不使用洋地黄的决定，往往是基于情感而非理性判断。从临床角度来看，区分肺部症状和体征与心脏症状和体征时所面临的诊断困难也令人困惑。小剂量洋地黄可能对心肌有正性肌力作用这一事实，对许多医生来说很难接受。另一方面，在控制室上性心律失常时心室反应常常需要较大剂量的洋地黄，这有时也会引起困惑。我们将试图详细回顾这个主题，并探讨洋地黄的适应证、禁忌证、毒性、剂量、疗效评估以及洋地黄血清水平在患者管理中的作用。
