美托洛尔静脉注射治疗快速心房颤动疗效评价

目的:观察美托洛尔(商品名:倍他乐克)注射液治疗快速心房颤动(房颤)的疗效及安全性。方法:42例快速房颤患者随机分为美托洛尔组与西地兰组,美托洛尔组21例予美托洛尔注射液5～15mg静脉注射,西地兰组21例予西地兰注射液0.4～0.8mg静脉注射,分别观察治疗前及治疗后40min、60min及120min患者心率及血压的变化。结果:1.2组患者分别有12例和8例在120min内心室率降至<100次/min,2组比较差异无显著性(57.14%vs38.09%,P>0.05)。2.美托洛尔组患者心室率降至<100次/min所需的时间为(18.33±12.31)min,西地兰组心室率降至<100次/min所需的时间为(65.00±35.05)min,2组比较差异有显著性(P<0.01)。3.美托洛尔静注起效平均时间(14.00±9.95)min,西地兰静注起效平均时间为(62.50±41.66)min,二者比较差异有显著性(P<0.01)。4.美托洛尔组总有效率85.71%(18/21),西地兰组总有效率47.62%(10/21),2组比较差异有显著性(P<0.01)。5.美托洛尔组治疗主要不良反应为低血压,无心力衰竭及严重心律失常。结论:美托洛尔静脉注射治疗快速房颤安全有效,为急诊科治疗快速房颤的可靠方法。

The evaluation on the therapeutic effect of intravenous metoprolol on patients with rapid atrial fibrillation

Objective:To observe the therapeutic effect and safety of intravenous metoprolol on atrial fibrillation. Method:Forty-two patients were divided into metoprolol group and cedilanid group randomly. The twenty-one patients in metoprolol group were injected metoprolol intravenously at doses of 5～15 mg. The twenty-one patients in cedilanid group were injected intravenously at doses of 0.4～0.8 mg. The heart rate and blood pressure before the injection and 40 min, 60 min and 120 min after the injection were observed respectively. Result:1. There were twelve cases and eight cases respectively in two groups whose heart rate decreased to less than 100 bpm. There were no significant differences between the two groups ( P >0.05). 2. The average time in metoprolol group and cedilanid group whose heart rate decreased to less than 100 bpm is (18.33±12.31) min and (65.00±35.05) min respectively. There was significant difference between two groups ( P <0.01). 3. The average time of becoming effective of intravenous metoprolol is (14.00±9.95) min, while that of becoming effective of intravenous cedilanid is (62.50±41.66) min, There was significant difference between two groups ( P <0.01). 4. The total effective rate of intravenous metoprolol and cedilanid is 85.71% and 47.62% respectively, There was significant difference between two groups ( P <0.05). 5. The most frequent adverse effect of metoprolol observed during the study was hypotension. No cardiac insufficiency and severe arrhythmias occurred. Conclusion:It is effective and safe that administering intravenous metoprolol to patients with rapid atrial fibrillation. And intravenous metoprplol has been another credible way of treating rapid atrial fibrillation in emergency department.