治疗心房颤动新药决奈达隆  

Dronedarone:a new agent for treatment of atrial fibrillation

作　　者：邓万俊[1] 

机构地区：[1]南华大学附属南华医院心内科,湖南衡阳421002

出　　处：《中国新药与临床杂志》2010年第1期5-10,共6页Chinese Journal of New Drugs and Clinical Remedies

摘　　要：决奈达隆为新型苯并呋喃衍生物,结构与胺碘酮相似。决奈达隆具有多通道阻滞的电生理特性。Ⅲ期临床试验证实,决奈达隆能有效减少心房颤动(Af)或心房扑动(AF)的复发,减慢Af/AF的心室率,减低心血管发病率及病死率。但在一项纳入重度心力衰竭(HF)及左室功能障碍患者的研究中,决奈达隆使病死率升高。决奈达隆耐受性好,不明显延长QTc间期,无显著肺、甲状腺、肝、眼和神经系统毒性,最常见的不良反应为腹泻、恶心及呕吐。决奈达隆可选择性用于Af/AF的治疗。但在预防Af复发时,决奈达隆疗效逊于胺碘酮,尚需更多有关决奈达隆与胺碘酮疗效的对比研究以确立决奈达隆在治疗中的地位。Dronedarone is a new benzofuran derivative structurally similar to amiodarone.It is a multichannel blocker with electrophysiological properties.Phase Ⅲ clinical trials showed that dronedarone was effective at reducing recurrence of atrial fibrillation （Af） or atrial flutter （AF）,reducing ventricular rate,and reducing cardiovascular morbidity and mortality in patients with Af /AF.However,dronedarone was associated with increased mortality in one study that included patients with severe heart failure （HF） and left ventricular dysfunction.Dronedarone appeared to be well tolerated.It did not significantly prolong the QTc,and no significant pulmonary,glandula thyreoidea,hepatic,ocular,or neurologic toxic effects were observed.The most common adverse reactions included diarrhea,nausea and vomiting.Dronedarone might be a treatment option for patients with Af /AF.However,dronedarone was less effective for the prevention of recurrent Af compared with amiodarone.Further comparative studies with amiodarone are needed to define dronedarone＇s place in therapy more clearly.

关 键 词：心房颤动 心房扑动 胺碘酮 决奈达隆 

分 类 号：R972.2[医药卫生—药品]