低剂量索他洛尔治疗老年房颤的疗效及安全性评价

目的探讨低剂量索他洛尔（80～160mg/d）对老年房颤的疗效及安全性。方法选择60例年龄大于65岁的房颤患者随机接受索他洛尔（施太可）或可达龙治疗。施太可的剂量每天80mg开始，未达到疗效者每周增加40mg/d,直至达到疗效或剂量增加到160mg/d。可达龙组剂量每天200mg/d。未达疗效者每周增加100mg/d，直至达到疗效或剂量增加到400mg/d。疗效及不良反应采用临床及动态心电图结果评定。结果①施太可组及可达龙组治疗老年房颤的总有效率分别为63.3%与62.1%(P＞0.05);②治疗第一周后施太可组的有效率为26.7%较可达龙组一周后的有效率10.3%明显较高（P＞0.05）；③施太可组房颤的有效率与平均心率下降呈显著的负相关(r=-0.85，P＜0.001)与QTc延长无显著的正相关（r=0.74，P＜0.001）；④施太可组有2例（6.7%）出现轻度副作用，包括无力、头晕、耳鸣，均能耐受，无1例出现尖端扭转型室速。结论低剂量索他洛尔（80～160mg/d）治疗国人老年房颤的疗效确切，副作用少，无明显的致心率失常作用。

Efficacy and Safety Evaluation of Low-dose Sotalol on Atrial Fibrillation in the Elderly Patients of China

OBJECTIVE：To investigate the efficacy and safety of l ow-dose(80～160mg/d) sotalol on atrial fibrillation in the elderly patients of C hina.METHODS：Total 60 patients,65～89 years old with atrial fib rillation entered the randomized study,30 patients received sotalol and 30 recei ved amiodarone.There were no significant differences in baseline clinical charac teristics between groups.Patients randomized to sotalol began with 80mg/d.After first and second week,the dosage was added 40mg/d for those who had not reached the responsible criteria,patients randomized to amiodarone began with 200mg/d,me anwhile 100mg/d would be added for those who had not reached the responsible cri teria until the dose reached the maximum(400mg/d).Holter monitoring was used to assess the arrhythmias.RESULTS：①The total efficacy rate of sot alol was 63.3% and that of amiodarone was 62.1%(P＞0.05).②After the first week of treatment, the efficacy rate of sotalol reached 26.8% and that of Amiodrone was 10.3%(P＜0.05).③There was signifcant relativi ty between efficacy rate of sotolol and average heart rate decreasing(r =-0.85,P＜0.001),and there was also signifcant relativity betw een efficacy rate of sotalol and lengthened QTc interval(r=0.74,P＜0.001).④The accident rate of side effect of sotalol was 6.7%,no patients di scontinued sotalol therapy.CONCLUSION：Low-dose sotalol(80～160m g/d)was efficient and safe in the Chinese patients with atrial fibrillation.