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1、冠心病：無(wú)癥狀心絞痛心肌梗死心律失常猝死心律失常：冠心病高血壓心衰糖尿病洋地黃等中毒心律失常的食療FoodTherapyofCardiacArrythmias3Atermforanyofalargeandheterogeneousgroupofconditionsinwhichthereisabnormalelectricalactivityintheheart.Theheartbeatmaybetoofastortooslow,andmayberegularorirregular.心律失常（綜合征）1.房性2.房室結(jié)性3.房室性4.室性5
2、.傳導(dǎo)阻滯6.猝死心律失常的西醫(yī)治療:發(fā)作控制，預(yù)防發(fā)作1.起搏器2.除顫器(ICD)3.射頻消融4.手術(shù)5.藥物:早搏，急性嚴(yán)重發(fā)作控制，貧困患者心律失常的發(fā)生機(jī)制點(diǎn)沖動(dòng)產(chǎn)生或/和傳導(dǎo)異常1.折返，Reentry2.自律性提高，RaisedAutomaticity3.后除極，Afterdepolarization4.異常基因表達(dá)，Abnormalgeneexpression心肌病變藥物毒性兒茶酚胺酸堿中毒缺血乏氧Re-entryoccurwhenanelectricalimpulserecurrentlytravelsinatightci
3、rclewithintheheart,ratherthanmovingfromoneendofthehearttotheotherandthenstopping.Everycardiaccellisabletotransmitimpulsesineverydirection,butwillonlydosooncewithinashortperiodoftime.Normally,theactionpotentialimpulsewillspreadthroughtheheartquicklyenoughthateachcellwillonl
4、yrespondonce.However,ifconductionisabnormallyslowinsomeareas,partoftheimpulsewillarrivelateandpotentiallybetreatedasanewimpules:atrialflutter,mostparoxysmalsupraventriculartachycardia,anddangerousventriculartachycardia.自律性：Automaticity后除極：AfterdepolarizationPhase2--NaPhase
5、3--CaPhase4--3Nainward/Caoutward基因缺陷多離子靶點(diǎn)假說(shuō)基因治療靶向治療西醫(yī)治療心律失常藥物的分類：1.自律性增高2.后除極3.折返4.異?；虮磉_(dá)降低自律性阻斷后除極消除折返基因治療多靶點(diǎn)治療ClassificationofAnti-ArrythmiaAgents?1.第一類:鈉通道阻滯劑Ia---Trecovery=1-10s奎尼丁,普魯卡因胺Ib---Trecovery<1s利多卡因,苯妥英Ic---Trecovery>10s普羅帕酮2.Class2:Beta阻滯劑倍他樂(lè)克3.Class3:鈉鈣鉀阻滯Am
6、iodarone(胺碘酮）Sotalol(索他洛爾，IKr)4.Class4:CB,Verapamil(維拉帕米）目前心律失常防治藥物：美托洛爾阿替洛爾艾司洛爾3.心得安4.胺碘酮（可達(dá)龍）5.維拉帕米（異搏定）6.慢心律，利多卡因4.乙馬噻嗪（莫雷西秦）5.普羅帕酮（心律平）6.苯妥英鈉7.腺苷傷心藥一線藥物基礎(chǔ)藥物特殊用途AdsofAmiodaroneThedrugaffectsthetriiodothyronine(T3)andthyroxine(T4)metabolism.Iflong-termuse,thethyroidfunct
7、ionmaybedisturbed,andothersideeffectsoccur,suchascornealmicro-deposits,photosensitivity,pulmonaryfibrosis,bradycardia,A-Vblock,andventriculartachycardia.Class4:Verapamil維拉帕米SiteofAction:SinusandA-VnodesL-CBDecreaseofAutomaticity,conductivity,andexcitability一名女患者，82歲，有兒子陪同來(lái)
8、到心血管內(nèi)科。醫(yī)生囑咐其進(jìn)行心電、CT等檢查。當(dāng)天，沒(méi)有取出結(jié)果。第二天。老人家讓兒子來(lái)那結(jié)果。兒子給醫(yī)生看結(jié)果。醫(yī)生問(wèn)，患者呢？?jī)鹤诱f(shuō)：“老母親，啥病也沒(méi)有，就說(shuō)吃飯不香，過(guò)去
