胺碘酮治疗心力衰竭伴快速房颤的短时疗效观察  

Effects of Intravenous Amiodarone on Rapid Ventricular Rate in Patients with Atrial Fibrillation and Congestive Heart Failure

作　　者：赵贵锋[1] 葛德元[1] 胡桃红[1] 

机构地区：[1]中国人民解放军第二炮兵总医院心内科,北京市100088

出　　处：《中国全科医学》2007年第2期113-114,117,共3页Chinese General Practice

摘　　要：目的观察静脉应用胺碘酮治疗充血性心力衰竭（CHF）伴快速心房纤颤（AF）患者的短时疗效。方法72例CHF伴快速AF患者，心功能Ⅱ-Ⅳ级（NYHA），心室率≥120次／min；随机分为胺碘酮组、毛花苷组，各36例。在常规治疗基础上，胺碘酮组首次剂量给予胺碘酮150mg缓慢静注，随后1．5ms／min微量泵维持；毛花苷组首次剂量给予去乙酰毛花苷0．4mg或0．2mg缓慢静注，1h后无效者追加0．2mg。观察用药后不同时刻的心室率变化、药物平均起效时间及不良反应。结果两组患者用药后60、90、120min的心室率与用药前比较差异有显著性意义（P〈0．01），胺碘酮组用药后30min的心室率与用药前比较差别亦有显著性意义（P〈0．01）；用药后2h胺碘酮组患者心室率较用药前下降36％，毛花苷组下降26％；胺碘酮组与毛花苷组平均起效时间间差异有显著性意义（P〈0．01）；胺碘酮组和毛花苷组的治疗有效率分别为77．8％和72．2％（P〉0．05）；两组不良反应发生率均为11．1％。结论静脉应用胺碘酮治疗CHF伴快速AF短时疗效显著，患者不良反应较少。Objective To evaluate the short - term effect of intravenous amiodarone on rapid ventricular rate in patients with atrial fibrillation （AF） and congestive heart failure （CHF）. Methods Seventy - two patients with AF and CHF （ ventricular rate ≥ 120 beats/minute, NYHA class Ⅱ ～ Ⅳ ） were randomized into two groups ： （ 1 ） amiodarone group （ n = 36） ： the loading dosage of amiodarone 150 mg followed with 1.5 mg/min; （2） lanatoside group （n =36） ： the loading dosage of lanatoside 0. 4 mg or 0. 2 mg, more 0. 2 mg should be medicated if no effect occur one hour later. The ventricular rate, the mean response time and the adverse effect were recorded after medicating. Results The ventricular rate decreased significantly after medicating than that of pro - medicating in both groups （ P 〈0.01 ）. The extent of ventricular rate decreased was significantly larger in amiodarone group than that of the lanatoside group. The mean response time was （ 27. 8 ± 12. 4 ） minutes and （47.6 ± 13.7 ） minutes in amiodarone and lanatoside groups respectively （ P 〈 0. 01 ）. The total effective rate on controlling rapid AF was 77.8% （ amiodarone group） and 72. 2% （lanatoside group） respectively （ P 〉 0. 05 ）. The rate of adverse effect was 11.1% in both of groups. Conclusion It is of safety and rapid - effect for amiodarone in controllling the rapid ventricular rate in patients with AF and CHF.

关 键 词：胺碘酮 毛花苷 心力衰竭 充血性 心房纤颤 

分 类 号：R972.2[医药卫生—药品] R541.61[医药卫生—药学]