阵发性快速性心房颤动患者采用胺碘酮复律的量效关系与安全性分析  

Dose-response of amiodarone for cardioversion of paroxysmal atrial fibrillation with a fast ventricular rate

作　　者：林敬阳[1] 郑小春[2] 黄声鹏 LIN Jingyang;ZHENG Xiaochun;HUANG Shengpeng(Department of Cardiology, Zhejiang Provincal People＇s Hospital, Hangzhou 310014, China)

机构地区：[1]浙江省人民医院(杭州医学院附属人民医院)心内科,杭州310014 [2]浙江省人民医院(杭州医学院附属人民医院)药学部,杭州310014 [3]浙江省苍南县人民医院急诊科

出　　处：《心电与循环》2018年第3期181-183,共3页Journal of Electrocardiology and Circulation

摘　　要：目的观察注射不同负荷剂量胺碘酮对阵发性快速性心房颤动复律的疗效与安全性。方法回顾性收集78例在急诊室或者住院期间出现阵发性快速性心房颤动的患者。分为150mg组和300mg组。比较心房颤动复律的比率和不良反应率。结果用药后10min及6h内,300mg组的心房颤动复律的效率(36.0%、88.0%、96.0%)明显高于150mg组(11.3%、60.4%、83.0%)。两组比较,差异均有统计学意义(P<0.05)。150mg组出现静脉炎8例,复律后出现一过性显著窦性心动过缓2例。300mg组出现静脉炎2例,复律后出现一过性显著心动过缓1例,两组比较差异均无统计学意义(P>0.05)。两组均未见二度或三度房室传导阻滞、未见窦性停搏、未见新发心力衰竭。结论胺碘酮300mg负荷量的复律方案优于胺碘酮150mg负荷量方案,副作用无增加。Objective To observe the efficacy and safety of different load dose of amiodarone injection on cardioversion of paroxysmal atrial fibrillation（PAF） with a fast ventricular rate. Methods 78 cases of patients with PAF and a fast ventricular rate occurred in emergency department or during hospitalization were retrospectively enrolled and divided into 150 mg group and 300 mg group based on load dose of amiodarone injection. The success rate of cardioversion of PAF and adverse reaction rate were compared between the two groups. Results The success rate of PAF cardioversion was significantly higher in 300 mg group（36.0%、88.0%、96.0%）than in 150 mg group（11.3%、60.4%、83.0%） at 10 min and 6 hours after intravenous amiodarone（all P〈0.05）. Phlebitis and transient significant sinus bradycardia occurred in 8 and 2 cases in 150 mg group, and in 2 and 1 case in 300 mg group, respectively. No second-or third-degree atrioventricular block, sinus arrest and new heart failure occurred in both groups. Conclusion The regimen of 300 mg load dose amiodarone is superior to the regimen of 150 mg in atrial fibrillation cardioversion without additional adverse effect.

关 键 词：胺碘酮 阵发性快速性心房颤动 治疗 复律 

分 类 号：R541.75[医药卫生—心血管疾病]