胺碘酮治疗慢性阻塞性肺病快速心房纤颤的临床疗效

目的 探讨胺碘酮对慢性阻塞性肺病（COPD）患者快速心房纤颤（AF）的治疗作用。方法 将收入ICU符合入选条件的24例合并快速心房纤颤的COPD患者分为两组。试验组12例，采用常规临床治疗＋胺碘酮静脉注射，对照组12例采用常规临床治疗。动态监测两组患者治疗后心室率、心律和血压变化。结果 两组患者治疗后心室率均有降低，胺碘酮组入院时与入院后1、4、24小时，对照组入院时与入院后4、24小时比较差异均有显著性意义P〈0.01。试验组入院后1小时与4小时心室率均明显低于对照组P〈0．05；试验组入院后1、4与24小时的累积转复率均显著高于对照组P〈0．05；胺碘酮治疗期间未见明显不良反应。结论 应用小剂量静脉注射胺碘酮治疗慢性阻塞性肺病合并心房纤颤早期可收到良好的心率和节律控制。

Amiodarone for treatment of patients with chronic obstructive pulmonary disease concomitant atrial fibrillation

Objective To observe the efficacy of amiodarone in the management of chronic obstructive pulmonary disease(COPD) patients with atrial fibrillation(AF).Methods Twenty-four ICU patients with COPD concomitant AF who coincided with the inclusive criteria were randomly arranged either to standard therapy plus amiodarone treatment group(trial group) or to standard therapy alone group(control group).Continuous monitoring of ECG and BP were performent.Results The heart rate(HR) was lower at 1h,4h,24h after admission in trial group and 4h,24h in the control group than that on admission(P<0.01),;moreover at 1h and 4h after admission in trial group,the HR were lower than that in the control group(P<0.05).The successful reversion rates at 1h,4h and 24h after admission in trial group were higher than those of the control group(58.33% vs 8.33%,75% vs 16.67%,91.67% vs 33.33%,respectively,(P<0.05).No side effects requiring discontinuation of treatment were observed in either group.Conclusions Small dose of amiondarone therapy results in a more efficacious ventricular rate control and rhythm control for patients with COPD concomitant AF.