PDF(Pubmed)
Abstract：
Background: Landiolol, a highly cardioselective agent with a short half-life (2.4-4 min), is commonly used as a perfusor or bolus application to treat tachycardic arrhythmia. Some small studies suggest that prior oral β-blocker use results in a less effective response to intravenous β-blockers. Methods: This study investigated whether prior chronic oral β-blocker (Lβ) or no prior chronic oral β-blocker (L-) intake influences the response to intravenous push-dose Landiolol in intensive care patients with acute tachycardic arrhythmia. Results: The effects in 30 patients (67 [55-72] years) were analyzed, 10 (33.3%) with and 20 (66.7%) without prior oral β-blocker therapy. Arrhythmias were diagnosed as tachycardic atrial fibrillation in 14 patients and regular, non-fluid-dependent, supraventricular tachycardia in 16 cases. Successful heart rate control (Lβ 4 vs. L- 7, p = 1.00) and rhythm control (Lβ 3 vs. L- 6, p = 1.00) did not significantly differ between the two groups. Both groups showed a significant decrease in heart rate when comparing before and after the bolus administration, without significant differences between the two groups (Lβ -26/min vs. L- -33/min, p = 0.528). Oral β-blocker therapy also did not influence the change in mean arterial blood pressure after Landiolol bolus administration (Lβ -5 mmHg vs. L- -4 mmHg, p = 0.761). Conclusions: A prior chronic intake of β-blockers neither affected the effectiveness of push-dose Landiolol in heart rate or rhythm control nor impacted the difference in heart rate or mean arterial blood pressure before and after the Landiolol boli.
摘要：
背景：兰地洛，具有短半衰期（2.4-4分钟）的高心脏选择性药物，通常用作灌注器或推注应用来治疗心动过速性心律失常。一些小型研究表明，先前口服β受体阻滞剂的使用会导致对静脉β受体阻滞剂的有效反应。方法：这项研究调查了在患有急性心动过速性心律失常的重症监护患者中，先前的慢性口服β受体阻滞剂（Lβ）或先前没有慢性口服β受体阻滞剂（L-）的摄入是否会影响静脉推注剂量兰地洛尔的反应。结果：分析了30例患者（67[55-72]年）的疗效，10人（33.3％）和20人（66.7％）没有口服β受体阻滞剂治疗。14例患者的心律失常被诊断为心动过速性心房颤动，非流体依赖性，室上性心动过速16例。成功控制心率（Lβ4与L-7，p=1.00）和节律控制（Lβ3与L-6，p=1.00）在两组之间没有显着差异。在推注给药前后比较，两组均显示心率显着降低，两组间无显著差异(Lβ-26/minvs.L--33/min,p=0.528)。口服β受体阻滞剂治疗也不影响兰地洛尔推注后平均动脉血压的变化（Lβ-5mmHg与L--4mmHg,p=0.761）。结论：先前长期摄入β受体阻滞剂既不会影响推动剂量兰地洛尔在心率或心律控制中的有效性，也不会影响兰地洛尔推注前后心率或平均动脉血压的差异。
