胺碘酮与心律平应用于房颤转复与维持窦律96例对比分析  

Efficacy comparision of intravenous amiodarone and propafenon for atriarl fibrillation

作　　者：赵京文[1] 高晖[1] 

机构地区：[1]西安市第四医院心内科,西安710004

出　　处：《陕西医学杂志》2008年第1期80-82,共3页Shaanxi Medical Journal

摘　　要：目的:观察应用胺碘酮与心律平对阵发性快速心房颤动(房颤)的治疗效果。方法:选择96例患者按就诊顺序随机分为两组,A组(49例):胺碘酮150mg+生理盐水10ml静脉注射,10min注射完毕;B组(47例):心律平70mg+生理盐水10ml静脉注射,5～10min注射完毕。观察10～20min若未转复可重复应用,最大累积量胺碘酮为450mg,心律平为210mg。A组复律成功者继续服用胺碘酮0.2g,每天1次维持。B组复律成功者继续接受心律平治疗,150mg,每8小时1次维持,结果:转复率:胺碘酮组75.51%(37/49),心律平组48.94%(23/47),两组转复率比较有显著性差异(χ2=6.14,P<0.05)。复律后维持窦律的疗效:胺碘酮组的维持率均明显高于心律平组,且两组相比均有显著性差异。随访1,3,6,12月胺碘酮组左心房直径缩小,左心室舒张早期经二尖瓣血流的最高值(E峰值)和左心房收缩时经二尖瓣血流的最大值(A峰值)、E/A增大。1,3,6,12月间比较极有显著性差异(P<0.01)。结论:胺碘酮和心律平对阵发性快速房颤均有较高的转复率,胺碘酮复律后窦律维持率高于心律平,胺碘酮对逆转心房心肌重构安全有效。Objective： To evaluate the efficacy of intravenous amiodarone and propafenon for atriarl fibrillation（AF）. Methods： 96 patients were divided into two groups randomly. Group A （49 patients） was treated intravenously with 150 mg amiodarone and 10ml normal saline within 10min. Group B（47 patients） was treated intravenously with 70mg propafenon and 10ml normal saline within 5 - 10 min. After 10- 20 min, when the resuscitation was not good, the above intravenous injections were given again, the maximum accumulated dose was 450mg（AM） and 210mg （propafenon）, The patients resuscitated in group A were given amiodarone 0. 2g per day, People resuscitated in group B were given propafenon 150 mg every 8 hours. Results： The resuscitation rate of 2 groups was 75. 51% （37 /49） and 48.94% （23/47） respectively（9（χ^2=6. 14, P〈0.05）. At 12 month after treatment period, there was a significant higher sinus rhythm ratio in amiodarone than in propafenone group （P〈0. 01）. There were a smaller left atrial diameter, a higher peak value of blood flow via mitral valve at early left ventricular diastole period （E value） , a higher peak value of blood flow via mitral valve at left atrial diastole period （A value） and a higher E/A ratio at 1,3, 6 and 12 month after treatment period than before treatment in amiodarone group ,with a significant difference between any two different timepoints （P〈 0. 01）. Conclusions： Both amiodarone and propafenon have high efficacy for treatment of AF, but amiodarone is better in reversion of atrial remodeling.

关 键 词：心房颤动/药物疗法 胺碘酮/治疗应用 钠通道阻滞剂/治疗应用 对比研究 

分 类 号：R541.705[医药卫生—心血管疾病] R541.75[医药卫生—内科学]