胺碘酮治疗慢性心力衰竭伴快速心房纤颤86例的疗效评价

【目的】评价胺碘酮治疗充血性心力衰竭（CHF）伴快速心房颤动（Af）患者的临床疗效及安全性。【方法】本院86例CHF伴快速Af（心功能级Ⅱ～Ⅳ级）患者，随机分为胺碘酮组（A组）、毛花洋地黄甙组（B组），每组43例。在常规治疗的基础上，A组首次剂量给予150mg胺碘酮缓慢静注，随后0．5-1．0rag／rain微量泵维持；B组首次剂量给予毛花洋地黄甙0．4mg或0．2mg缓慢静注，1h后无效者追加0．2mg。观察用药后12h临床疗效、心电图改善、30、60、90min转复成功率及不良反应。【结果】两组患者用药后临床疗效比较差异无显著性（P〉0．05）；A组与B组心电图表现：转复为窦性心律及基础心室率下降分别为17例（占39．53％）、24例（占55．81％），8例（占18．60％）、19例（占44．19％），两者比较差异有显著性（P〈0．05）；A组窦性心律转复成功率显著高于B组（P〈0．05）；两组不良反应相比无显著性差异（P〉0．05）。【结论】静脉应用胺碘酮治疗CHF伴快速Af比毛花洋地黄甙更加快速、安全、有效。

Evaluation of the Efficacy of Amiodarone for the Treatment of 86 Cases of Chronic Heart Failure with Rapid Atrial Fibrillation

[Objective] To evaluate the clinical efficacy and safety of amiodarone for the treatment of conges tire heart failure（CHF ） with rapid atrial fibrillation（Af）. [Methods] Totally 86 CHF patients with Af （NYHA class Ⅱ to Ⅳ） in our hospital were randomly divided into amiodarone group and Maohua digitalis glycoside group with 43 cases in each group. Based on the routine treatment, amiodarone group received slow intravenous injection of first dose of amiodarone 150mg, and then 0.5-1.0mg/min micro pump was used for maintenance. Maohua dig- italis glycoside group received slow intravenous injection of first dose of Maohua digitalis glycoside 0.4mg or 0.2 mg, and then 0.2mg Maohua digitalis glycoside was appended for nonresponders after lh. Clinical efficacy, dee- trocardiogram（ECG） improvement, cardioversion successful rate at 30min, 60min and 90min and adverse reaction were observed after medication for 12h. [Results] There was no significant difference in clinical efficacy after med ication between two groups （ P 〉 0. 05）. The ECG of amiodarone group and Maohua digitalis glycoside group showed that the cardioversion of sinus rhythm and the decreasing of basic ventricular rate were found in 17 patients （39.53%）, 24 patients（55.81%）, 8 patients（18. 60%） and 19 patients（44.19%）, respectively, and there were significant differences between them（ P 〈0.05）. The cardioversion successful rate of sinus rhythm in amiodarone group was markedly higher than that in Maohua digitalis glycoside group（ P 〈0.05）. There was no significant difference in adverse reaction between two groups（ P 〉0.05）. [Conclusion] Intravenous amiodarone for the treat- ment of CHF with Af is more rapid, safer and more effective than Maohua digitalis glycoside.