静脉注射美托洛尔、地尔硫卓治疗快速房颤的临床疗效对比

目的观察静脉注射美托洛尔和地尔硫卓治疗快速房颤的有效性和安全性。方法选取我院的80例快速房颤患者,随机分为两组,各40例。美托洛尔组,采用5 mg缓慢静脉注射,观察5 min,如无严重低血压等反应或效果不明显则重复1次,最多给药3次,总量10～15 mg;地尔硫卓组采用0.25 mg/kg,稀释后静脉注射,观察15 min,如无效重复1次,然后10mg/h维持。记录用药前后心室率和血压的变化,并比较在各观察时间点上的有效率。结果美托洛尔组的有效率是82.5%,用药前心室率是（145.56±9.93）次/min,用药后120 min降至（102.15±18.75）次/min,下降幅度29.82%;地尔硫卓组的有效率是91.6%,用药前心室率是（145.58±11.24）次/min,用药120 min后降至（90.60±19.22）次/min,下降幅度37.77%。两组血压有下降但多在正常范围,无严重不良反应。结论静脉注射美托洛尔和地尔硫卓均能快速、有效、安全控制快速房颤的心室率,但是地尔硫卓控制心室率下降幅度更大,起效更快。

Contrasting the effectiveuess of Metoprolol and Diltiazem in rapid atrial fibrillation just by intravenous injection

Objective To observate the effectiveness and safety of Metoprolol and Diltiazem by intravenous injeoting.Methods 80 patients with rapid atrial fibrillation in our hospital were divided into two groups randomly, each group with 40 patients.Metoprolol group, using 5 mg Metoprolol by intravenous injecting slowly and observating for 5 minites.If it was no serious reactions such as hypotension or the effect was not obvious,to give it once more.But no more than 3 times,or 10 ～ 15 mg.Diltiazem group,using Diltiazem 0.25mg/kg by intravenous injecting, and observating for 15 minites.If it was no effect, to do this once more, then keeping 10mg per hour.Recorded the changes in heart rate and blood pressure before and after the treatment.Compared the efficient at all time points.Results In the Metoprolol group, response rate was 82. 5% and heart rate was( 145.56 ± 9.93) times/min before treatment.After 120 minutes,heart rate fell to (102. 15 ± 18.75) times/min, decrease of 29.82%.In the Diltiazem group, response rate was 91.6% and heart rate was( 45.58 ± 11.24) times/min before treatment.After 120 minutes, heart rate fell to (90.60 ± 19.22) times/min, decrease of 37.77%.The blood pressure of two groups all dropped, but more in the normal range, no serious adverse reaetions.Conclusions Intravenous injection of Metoprolol and Diltiazem can fast, effectively, safely and rapidly control of ventricular rate in atrial fibrillation, but ventricular rate in the control of Diltiazem drop even more sharply, more effectively.