盐酸索他洛尔治疗先天性心脏病患儿术后室上性心动过速的疗效  

Efficacy of sotalol hydrochloride on supraventricular tachycardia after surgery in children with congenital heart

作　　者：魏丹[1] 郭保静[1] 贺彦[1] 刘迎龙[1] 

机构地区：[1]首都医科大学附属北京安贞医院小儿心脏科术后监护室,100029

出　　处：《中华实用儿科临床杂志》2013年第13期1023-1025,共3页Chinese Journal of Applied Clinical Pediatrics

基　　金：首都市民健康项目培育（Z111100074911001）

摘　　要：目的 观察盐酸索他洛尔治疗CHD患儿术后室上性心动过速的疗效。方法 收集2005年9月至2012年3月首都医科大学附属北京安贞医院小儿心脏科行 CHD 手术治疗且术后发生室上性心动过速，并予盐酸索他洛尔片口服治疗的患儿21例。将患儿按照盐酸索他洛尔不同给药剂量分为3组，Ⅰ组≤0.30 mg/ （kg·次），Ⅱ组0.31～0.80 mg/（kg·次），Ⅲ组0.81～2.00 mg/（kg·次）。比较各组显效率、给药前后不同时间点心率、收缩压、中心静脉压（CVP）。观察是否发生心动过缓、QT间期延长、尖端扭转型室上性心动过速等恶性心律失常。结果 Ⅰ组、Ⅱ组和Ⅲ组显效率分别为16.7% 、20.0% 和100% 。Ⅲ组显效率最高，3组显效率比较差异有统计学意义（P 〈0.05）。Ⅰ组、Ⅱ组和Ⅲ组心率下降最大比例分别为17.2% 、21.5% 和34.9% ，用药2、4、8、12 h Ⅲ组的心率均低于Ⅰ组和Ⅱ组，但仅术后8 h心率差异有统计学意义（P 〈0.05）。3组用药后不同时间点收缩压及CVP变化均不明显，差异均无统计学意义（P均 〉0.05）。全组病例未发生心动过缓、QT间期延长、尖端扭转型室上性心动过速等恶性心律失常。结论 盐酸索他洛尔用于CHD术后室上性心动过速的治疗安全有效，不良反应小。剂量越大疗效越显著。Objective To observe the efficacy of sotalol hydrochloride on supraventricular tachycardia after surgery in children with congenital heart disease（CHD）. Methods Twenty-one cases were observed from Sep. 2005 to Mar. 2012 from Beijing Anzhen Hospital Affiliated to Capital Medical University, who had sotalol hydrochloride for su-praventricular tachycardia after CHD surgery. All patients were divided into 3 groups according to different dosage of so-talol hydrochloride,group Ⅰ ： ≤0.30 mg/（ kg · dose）, group Ⅱ ：0.31-0.80 mg/（ kg· dose）, group m 0 81-2. 00 mg/（ kg · dose）. The efficacy, the heart rate（HR） , systolic blood pressure（SBP） , central venous pressure（CVP） were compared at different time. If bradycardia,long QT syndrome, torsade de pointes and other arrhythmia happened were observed. Results The efficacy were 16.7% ,20.0% and 100% in group Ⅰ , group Ⅱ and group Ⅲ. The efficacy in group In was the highest and there was statistical difference in 3 groups（ P 〈 0.05 ）. The heart rate dropped separately 17.2% ,21.5% ,34.9% in 3 groups and the HR in group II1 was lower than group I and group 11 at different times, but it had statistically significant difference only at time of 8 hours after administration （P 〈 0.05 ）. The SBP and CVP dropped slightly and there was no statistical difference in SBP and CVP in 3 groups（ all P 〉 0.05 ）. There were no brad-ycardia,long QT syndrome and torsade de pointes, etc. Conclusions Sotalol hydrochloride is a safe and effective drug with slight side effect on supraventricular tachycardia after CHD surgery. The higher the dose, the better the efficacy.

关 键 词：室上性心动过速 盐酸索他洛尔 先天性心脏病 儿童 

分 类 号：R726.5[医药卫生—儿科]