口服奎尼丁转复心房颤动的临床分析

应用口服奎尼丁转复心房颤动（AF）393例次，评价其效果、安全性、血药浓度的意义及相关因素对转复的影响。奎尼了用量第1日每次0．2g，每2h1次，共5次。如未能转复逐日每次递增0．1g，至第3日仍未转复逐停药。有47例测了血药浓度。393例次AF中324例次（82．4％）转复成功，平均转复时间为13．7±5．1（2～42）h。高血压病、冠心病、心肌病及孤立性AF的转复率较风湿性心脏病者为高（93．8％、88．9％、88.9％、95.7％vs76.4％，P＜0．05）。AF持续时间＜6个月者转复率高于6～12及＞12个月者（88．2％vs69．2％、56．3％，P＜0．01）。左房内径＜50mm者转复率高于≥50mm者（89．7％vs72．0％，P＜0.05）。有效见药浓度为1．5～6．0ng／ml。未发现与奎尼丁有关的严重副作用。表明口服奎尼丁转复AF的成功率高，严重不良反应的发生率低，其仍不失为治疗AF的一种较好方法。

The Study of Oral Quinidine on Cardioversion of Atrial Fibrillation

To evaluate the efficacy,safety and utility of quinidine for cardioversion of atrial fibrillation (AF),thesignificance of serum-drug concentration and the influence of some factors on quinidine treatment. 393 cases weretreated with quinidine. All the patients took quinidine 3 days:the first day,quinidine 0. 2 g,q2h, 5 times;the secondday,quinidine 0. 3 g,q2h, 5 times and the third day,quinidine 0. 4,q2h, 5 times. The serum-drug concentration ofquinidine was measured in 47 cases. 324 of all 393 cases (82. 4% ) were cardioverted to sinus rhythm. The averagetime of cardioversion was 13. 7±5. 1 (2~42) hours. The successful rates in hypertension,coronary heart desease,myocardiopathy and isolated AF were higher than that in rheumatic heart desease (93. 8 %, 88. 9 %. 88. 9 %, 95. 7 %vs 76. 4 %,respectively,P<0. 05). The patients with short time AF (<6 months ) had a high successful rate thanthat in long time AF patients (6~12 and >12 months,P<0.01 ). The patients with small left atria (<50 mm)were easy to recover sinus rhythm (P<0.05). The serum quinidine level in the successful cases was 1. 5~6 ng/ml. No quinidine-induced syncope happened in this group and no patient died of quinidine cardioversion. Conclusion:Acording to our study,oral quinidine is a good therapeutic method for atrial fibrillaion in our country at presenttime,it is more effective,safe,and less adverse effects.