艾米奥达龙治疗药物耐药的胎儿心动减速
Janette F Strasburger1, Bettina F Cuneo, Maaike M Michon
1Children's Hospital of Wisconsin, Division of Cardiology, MS-713, 9000 W Wisconsin Ave, Milwaukee, WI 53201, USA. jstrasbu@mcw.edu
Circulation
|January 21, 2004
概括
阿米奥达龙是一种安全有效的治疗胎儿心动减速症,即使是胎儿水或心力衰竭,胎儿心动减速症也不对迪戈辛有反应. 这种疗法为受影响的新生儿提供了高的成功率和100%的存活率.
科学领域:
- 心脏病学 心脏病学
- 孕产妇和胎儿医学 孕产妇和胎儿医学
- 药理学 药理学是指药理学的学科.
背景情况:
- 胎儿高心率与胎儿水或心室功能障碍存在重大风险.
- 迪戈辛是第一线治疗,但在许多情况下是无效的.
- 在狄戈辛失效时,对于替代性抗心律失常疗法缺乏共识.
研究的目的:
- 评估移植性阿米奥达龙治疗的安全性和有效性.
- 为了评估药物耐药性心力衰竭和心力衰竭的胎儿的结果.
主要方法:
- 口服阿米奥达龙通过体外移植给患有持续性心力衰竭的胎儿,这些胎儿对狄戈辛和其他药物不耐药.
- 治疗包括加重剂量,然后进行维持疗法,并继续使用狄戈辛.
- 新生儿接受了心电图监测或食道间节奏调节,以确定心跳动机制.
主要成果:
- 阿米奥达龙成功地转化了93%的复发性上心室性心跳动,100%的心室/结节外皮心跳动和33%的心房动.
- 三个胎儿需要紧急分娩,三个需要额外的药物用于心脏转变.
- 在母亲和婴儿中观察到过渡性不良反应;100%的存活率是在平均妊娠年龄为37周时实现的.
结论:
- 口服阿米奥达龙是一种安全有效的治疗药物耐药的胎儿心动减速.
- 它特别有效治疗复发性脑上高心率,结节性宫外心率和心室高心率.
- 阿米奥达龙是一种可行的选择,即使存在胎儿水或心室功能障碍.
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