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对于顽固性室性心律失常,尤其是对于交感神经张力明显增高的患者,如单用胺碘酮无效,适量加用静脉或口服β受体阻滞剂有时可显奇效。因为高交感神经张力除了使室性心律失常不易终止和易复发外,还可削弱胺碘酮的延迟复极作用,在应用β受体阻滞剂后胺碘酮的药理作用方能充分发挥,且可与β受体阻滞剂对多种离子通道的阻滞作用相互增强。但在临床应用中,一定要结合患者的不同病理生理状态进行个体化给药,同时密切监测患者的心率、血压变化,做好临时起搏等抢救准备。要有全局观念,切忌只对心律失常、不对病人的教条化治疗。
For refractory ventricular arrhythmias, especially in patients with significantly increased sympathetic tone, such as the ineffective amiodarone alone, the amount of intravenous or oral β-blockers can sometimes be remarkable effect. Because of the high sympathetic tone in addition to the ventricular arrhythmia is not easy to stop and easy to relapse, but also to weaken the delayed repolarization of amiodarone, after the application of β-blocker amiodarone pharmacological effects side can give full play, And with β-blockers on a variety of ion channel blockade mutual enhance. However, in clinical application, we must combine the patient’s different pathophysiological state for individualized administration, while closely monitoring the patient’s heart rate, blood pressure changes, do a good job of temporary pacing and other rescue preparations. Should have the overall concept, avoid arrhythmia, not dogmatic treatment of the patient.