胺碘酮与普罗帕酮对心房颤动转复与维持窦律的疗效比较

目的：观察胺碘酮与普罗帕酮对心房颤动（简称房颤）转复与维持窦律的疗效和安全性。方法：选择98例房颤病程3天～5年患者首先接受华法令抗凝治疗3周，随机分为两组，A组（50例）：接受胺碘酮治疗，第一周为0．2g，每日3次口服，第二周0．2g，每日2次口服，如房颤未转复，则行电复律治疗；B组（48例）：接受普罗帕酮150mg．每8h1次，连续应用4d，如房颤未转复，则行电复律。A组复律成功者继续服用胺碘酮0．2g，每天1次维持。B组复律成功者继续接受普罗帕酮150mg，每8小时1次维持。结果：转复率：胺碘酮组12％（6/50），普罗帕酮组10％（5／48），两组转复率比较差异无显著性。复律后维持窦律的疗效：随访1个月，6个月，1年，2年，胺碘酮组的维持率均明显高于普罗帕酮组，两组比较差异均有显著性（P〈0．01）。结论：两组药物复律成功率相比差异无显著性，考虑与选择房颤病程多数在1年以上有关，但是复律后维持窦德方面胺碘酮优于普罗帕酮．

Efficacy comparison of amiodarone and propafenone on atrial fibrillation conversion and sinus rhythm maintenance

Objective ：To investigate the curative efficacy and safety of amiodarone and propafenone on atrial fibrillation conversion and sinus rhythm maintenance. Methods：98 cases of atrial fibrillation with the disease course of 3d to 5 years were selected and received the anticoagulation treatment by oral warfarin for 3 weeks.Then,the patients were randomly divided into 2 groups. Group A （50 cases） received oral amiodarone,0.2 g,three times daily, in 1-week,0.2 g,twiee daily in 2-week. If atrial fibrillation did not conversed, electrical eardioversion was performed. Group B （48 eases） received oral propafenone, 150 nag,once each 8h for continuous 4 d. If atrial fibrillation did not conversed,electrical eardioversion was performed. The patients with successful eardioversion in group A took amiodarone, 0.2 g once a day for maintenance. But the patients with successful cardioversion in group B were given propafenone, 150 tog, once per 8h for maintenance. Results：The conversion rate in the group A and B was 12% （6/50） and 10% （5/48） respectively with no significant difference. The eftlcaey of sinus rhythm maintenance after eardioversion：the maintenance rate of 1-month, 6-roonth, 1-year and 2-year followed-up in group A was obviously higher than that in group B with significant difference （P〈0.01）. Conclusion：The success rate of drug cardioversion between the two groups has no significant difference, due to the selective patients with the disease course of more than one year. Amiodarone is superior to propafenone in sinus rhythm maintenance after cardioversion.