快速型心房颤动患者静脉应用地尔硫卓和美托洛尔的疗效观察  

Comparison of the effectiveness of intravenous diltiazem and metoprolol in controlling the rapid ventricular rate in patients with atrial fibrillation

作　　者：刁鸿英[1] 刘斌[1] 陈宏勃[1] 史永锋[1] 王丽娟[1] 

机构地区：[1]吉林大学第二医院心内科,长春130041

出　　处：《中华急诊医学杂志》2009年第10期1085-1087,共3页Chinese Journal of Emergency Medicine

摘　　要：目的比较静脉注射地尔硫卓和美托洛尔控制心房颤动（简称房颤）患者快速心室率的疗效。方法吉林大学第二医院2003年1月至2006年7月收治的48例心室率〉120次／min且收缩压≥100mmHg的房颤患者分为地尔硫卓组（n=24）和美托洛尔组（n=24）。地尔硫卓和美托洛尔的用法分别为10mg和5mg静脉注射。记录用约后5min，10min，15min和30min时的患者的心率和血压。治疗有效的定义为用药30min后心率率下降至100次／min以下或较用药前的心率下降20％以上或转复为窦性心律。数据比较采用t检验、配对t检验及X^2检验。结果和用药前比较，两种药物在上述各个时间点均能显著降低房颤时的快速心室率（P〈0．01），但除用药后30min外，其它各时间点地尔硫卓组的心室率显著低于美托洛尔组（P〈0．05）。在降低心率率的同时，这两种药物亦使血压有所降低，但两组之间的降压作用差异无统计学意义。两组均未见药物所致的低血压者。用药后30min，地尔硫卓组和美托洛尔组的治疗有效率分别为91．7％和83．3％（P〉0．05）。结论静脉注射地尔硫卓10mg或美托洛尔5mg在30min均能使房颤时的快速心室率显著降低，尤以地而硫卓作用更强。Objective To compare the effectiveness between dihiazem and metoprolol administered intravenously on controlling the ventricular tachy-cardia in patients with atrial fibrillation （AF）. Method From January 2003 to July 2006, 48 AF patients in the Second Hospital, Jilin University, with a ventricular rate 〉 120 beats per minute and systolic blood pressure 〉 100 mmHg were enrolled and divided into diltiazem group （10 mg, IV, n = 24） or metoprolol group （5 mg, IV, n = 24）. Blood pressure and heart rate were re-checked at different intervals of 5, 10, 15 and 30 minutes, respectively. Successful treatment was defined as ventricular rate 〈 100 beat/ rain or decrease 〉 20% of the pre-treatment level, or restouration of sinus rhythm, Results Compared with pre-treatment value, a significant deceleration in ventricular response to AF was observed after treatment in both groups at each interval （ P 〈 0.01 ）. However, the ventricular rate in the diltiazem group was significantly lower than that in the metoprelol group （ P 〈 0.05） at all intervals but 30 minutes. A slight decrease in blood pressure was observed in both groups. The drop of blood pressure between two groups was comparable. The successful treatment at the interval of 30 minutes was achieved in 91.7 % of patients in dihiazem group and 83.3 % of patients in metoprolol group （ P 〈 0. 05）. Conclusions Both dihiazem （ 10 rag, IV） and metoproM （5 mg, IV） are effective on controlling the accelerated vcntricular response to AF, in particular, the effect of diltiazem seems much superior to ahat of metoprolol.

关 键 词：心房颤动 地尔硫卓 关托洛尔 静脉注射 疗效 

分 类 号：R541.4[医药卫生—心血管疾病]