硫酸镁在伊布利特转复房颤与房扑中的应用  

Effect of adjunctive use of intravenous magnesium on ibutilide to successfully convert atrail fibrillation or flutter

作　　者：张海燕 李小明 李海涛 张萍[3] 田芸[3] 赵笑春[3] 郭继鸿[3] 

机构地区：[1]秦皇岛市骨科医院,066000 [2]山西心血管病医院,030001 [3]北京大学人民医院,100044

出　　处：《临床心电学杂志》2013年第1期30-33,共4页Journal of Clinical Electrocardiology

摘　　要：目的观察预防性静脉应用硫酸镁对伊布利特转复房颤/房扑的疗效及安全性影响。方法回顾应用伊布利特药物转复房颤/房扑的患者76例,分为两组:对照组35例,单独应用伊布利特;试验组41例,伊布利特联合静脉预防性应用硫酸镁,观察两组患者在转复率、平均转复时间、致心律失常不良反应、药物相关QTc延长等方面的差异。结果两组间比较,总转复率、房颤/房扑转复率、平均转复时间、心动过缓、室性早搏、单形或多形性室速的发生率均无统计学差异。尖端扭转型室速(TdP)的发生率和总心律失常不良反应有显著差异。试验组治疗后QTc延长程度明显小于对照组,有显著统计学差异。女性、初始QTc为用药后室性心律失常发生的独立危险因素;△QTc为Tdp发生的独立危险因素。结论伊布利特转复房颤/房扑时预防性静脉应用硫酸镁可有效减少药物相关QTc过度延长、降低室性心律失常,尤其Tdp的发生率,并有可能提高转复疗效。Objective To observe the effect and the salty of using of intravenous magnesium with Ibutilide to convert atrial fibrillation or flutter. Methods We enrolled 76 adult patients who received intravenous Ibutilide to convert atrial fibrillation or flutter in the presence or absence of adjunctive intravenous magnesium. There were 35 patients in control group received intravenous Ibtilide; and 41 patients as the study group who received intravenous magnesium in addition to intravenous Ibutilide. We observed some factors including the conversion rate, the average conversion time, the adverse effects of arrhythmia, the QTc prolongation associated with drug （＆QTe）, and to analyze the drug related ventrienlar arrhythmias and the independent risk factors of Tdp. Results There were no significant difference between the two groups about the general baseline data, the total conversion rate of atrial fibrillation or atrial flutter, the average conversion time, bradyeardia, ventricular premature beats and single or polymm]）hic ventrieular tachycardia. There was significant different between Tdp and G QTe. Conclusions Intravenously using magnesium can attenuate the QT prolongation in patients using Ibutilide to convert atrail fibrillation or flutter, the occurrence of Tdp reduced especially, and probably enhance the ability of Ibutilide to successfully convert atrial fibrillation or flutter.

关 键 词：硫酸镁 伊布利特 QTC 室性心律失常 

分 类 号：R541.7[医药卫生—心血管疾病] R540.41[医药卫生—内科学]