胺碘酮联合倍他乐克预防冠状动脉旁路术后房颤

目的研究胺碘酮联合倍他乐克在预防冠状动脉旁路移植(CABG)术后房颤中的作用。方法常规体外循环(CPB)下CABG患者176例随机分为试验组(90例)和对照组(86例)。对照组术前、术后常规服用倍他乐克。试验组倍他乐克用法同上但加用胺碘酮。两组比较CABG术后房颤的发生率。试验终点为术后第30天。结果CABG术后两组比较,试验组房颤发生率(6.7%)小于对照组(22.1%)(P<0.05)。两组内60岁以下患者房颤发生率比较无统计学意义,两组内60岁以上患者房颤发生率比较,差异有统计学意义(P<0.05)。试验组内部<60岁与≥60岁患者房颤发生率比较无区别,而对照组则存在显著差异(P<0.05)。结论胺碘酮联合倍他乐克在预防冠状动脉旁路移植(CABG)术后房颤中的作用优于单用倍他乐克,能进一步降低CABG术后房颤的发生率。尤其对于60岁以上患者效果更加明显。我们推荐60岁以上患者,CABG术后在倍他乐克基础上积极应用胺碘酮,预防房颤的发生。

Combined Amiodarone and Betaloc in Prevention Atrial Fibrillation after Coronary Artery Bypass Grafting

Objective The purpose of the present study was to evaluate the effect of combined amiodarone and betaloc on prevention of atrial fibrillation(AF)after coronary artery bypass grafting.Methods One hundred and seventy-six patients after coronary artery bypass grafting were randomized to receive combined amiodarone and betaloc(50 mg/d)(n=90)or betalocmonotherapy(50 mg/d)(n=86)for 30 days.Results The incidence of AF was higher in patients of 60 years old than that of <60.Combined theraphy significantly decrease the incidence of AF compared with that of monotherapy by betaloc(6.7% vs 22.1%,P<0.05)and abolished the differences of incidences of AF between ages.Conclusion The combination of amiodarone and betaloc is more effective than betaloc monotherapy in decrease the incidence of AF after CABG especially in elderly patients.