Ibutilide转复心房颤动的Meta分析  

A Meta-analysis for Rapid Conversion of Atrial Fibrillation/Flutter With Ibutilide.

作　　者：梁岩[1] 高鑫[1] 朱俊[1] 

机构地区：[1]中国医学科学院心血管病研究所中国协和医科大学阜外心血管病医院急诊科,北京100037

出　　处：《中国心脏起搏与心电生理杂志》2001年第6期394-398,共5页Chinese Journal of Cardiac Pacing and Electrophysiology

摘　　要：应用Meta分析的方法评价静脉使用Ibutilide转复心房颤动 (简称房颤 )和 (或 )心房扑动 (简称房扑 )的疗效及副作用。检索公开发表的英文及中文相关文献 ,并建立数据库 ,应用Meta统计分析方法 ,按观察时间、给药方法、房颤、房扑类型等对数据进行综合分析。共 16项试验 15 13例患者入选本研究。经统计 ,静脉推注Ibutilide能有效转复房颤或房扑 ,2 0 ,30 ,6 0min转复率分别为 14.9%、2 1.2 %、33.7% ,90min总转复率为 38.4% ,且房扑转复疗效优于房颤 (转复率差 2 4.5 % ,P <0 .0 0 1)。Ibutilide转复房颤、房扑与安慰剂相比的疗效率差在 2 0 ,6 0 ,90min分别为16 .1%、30 .4%及 38.7% (P <0 .0 0 1)。主要副作用为用药早期出现多型性室性心动过速 ,多在静脉推注药物后 40min内发生。结论 :Ibutilide能有效转复房扑及房颤 ,但须在严格监控下进行。The purpose of this study was to determine the efficacy and safety of intravenous ibutilide in terminating recent onset atrial fibrillation or flutter using meta analysis techniques.Published abstracts and manuscripts with these goals were selected and data abstracted on conversion to sinus rhythm.Data were pooled using standard meta analytic techniques and analyzed according to observation times,route of drug administration and type of atrial arrhythmias.Sixteen trials involving 1513 patients published Form 1993 to 2000 were selected.The conversion rate of ibutilide was 14.9%,21.1%,33.7% and 38.4% at 20,30,60 and 90 minutes after infusion respectively.Efficacy was higher in atrial flutter than fibrillation (rate difference 24.5%, P< 0.001).The pooled rate difference of patients terminated between ibutilide and placebo was 16.1%,30.4% and 38.7% at 20,30,60 and 90 minutes ( P< 0.001 at all time intervals).The major adverse event was polymorphic ventricular tachycardia which developed during or soon after the infusion.These data demonstrated that ibutilide was effective in rapidly terminating atrial fibrillation or flutter and under monitored conditions was necessary to current cardioversion options.

关 键 词：心房颤动 心房扑动 IBUTILIDE 心脏复律 

分 类 号：R541.705.5[医药卫生—心血管疾病] R972.2[医药卫生—内科学]