美托洛尔注射剂治疗快速房性心律失常的临床研究

目的观察静脉应用美托洛尔控制快速性房性心律失常心室率的有效性及安全性。方法30例快速性房性心律失常、心室率>120次/分的患者随机分为美托洛尔组和西地兰组。观察用药前(0min)、第二剂前、第三剂前;首剂用药后40,60,90min和120min时的心率和血压。用药后心室率降至100次/分以下或转复窦性心律为有效。结果30例快速性房性心律失常(心房颤动20例,心房扑动5例,房性心动过速5例)患者,男17例,女13例,年龄57.3±12.4岁,随机分入美托洛尔组和西地兰组。在60min内各观察时间点,美托洛尔组明显优于西地兰组,两组有效率分别为53.3%、86.7%、93.3%和93.3%对13.3%、20.0%、40.0%和60.0%。两组平均起效时间美托洛尔组为12.6±6.7min和西地兰组为53.0±28.4min,美托洛尔组明显短于西地兰组。120min内两组总有效率分别为93.3%、80%,无显著差异。结论静脉应用美托洛尔及西地兰均能有效安全地控制快速性房性心律失常的心室率,美托洛尔起效较西地兰更快。

Efficacy of intravenous metoprolol in the treatment of atrial tachyarrhythmia

Objective To investigate the efficacy and safety of intravenous (IV) metoprolol in controling ventricular rate of atrial tachyarrhythmias. Methods Thirty atrial tachyarrhythmic patients with a ventricular rate >120 bpm were included and randomised to inject metoprolol or cedilanid. Blood pressures and heart rate were measured at base line (0min), before the second dosage, before the third dosage, 40, 60, 90, and 120 mins after injection . The effective criteria was defined as decreased ventricular rate <100 bpm or returning to sinus rhythm. Results Thirty patients (17 male, mean age 57.3±12.4 years), including 20 cases of atrial fibrillation, 5 cases of atrial flutter and 5 cases of atrial tachycardia,were randomised to metoprolol group or cedilanid group.The effective rate in the metoprolol group was significantly higher than that in the cedilanid group (53.3%, 86.7%, 93.3%, and 93.3% versus 13.3%, 20.0%, 40.0%, and 60.0%, respectively within 60 minutes. P<0.05). The mean duration of achieving effectiveness for metoprolol and cedilanid was 12.6±6.7 mins and 53.0±28.4 mins, respectively (P<0.01). The totally effective rate between two groups was not significantly different (93.3% in metoprolol group vs 80% in cedilanid group, P>0.05). Conclusion Both metoprolol and cedilanid are effective and safe for the management of rapid ventricular rate in atrial tachyarrhythmia. However, the efficacy of ventricular rate control begins earlier with metoprolol than with cedilanid.