静脉应用地尔硫卓和美托洛尔治疗老年心功能衰竭伴心房颤动快速心室率的疗效和安全性比较

目的比较在中重度心功能衰竭伴心房颤动快速心室率的老年患者静脉注射地尔硫卓和美托洛尔控制心室率的有效性和安全性。方法采用随机单盲方法,将72例中重度心功能衰竭伴心房颤动快速心室率的老年患者分为2组,分别给予地尔硫卓和美托洛尔静脉注射,观察有效率及血压、症状和体征变化。结果地尔硫卓组有效率为94.6%,用药前心室率为149±26次/min、用药后120min降至97±19次/min,下降幅度为35%;美托洛尔组有效率为97.1%,用药前后心室率分别为150±27、95±18次/min,下降幅度为37%。两组血压均有下降但多在正常范围,地尔硫卓组无心功能恶化,美托洛尔组1例心功能恶化。结论静脉注射地尔硫卓和美托洛尔均能有效地控制老年中重度心功能衰竭患者的心房颤动快速心室率,且相对安全。

A Comparative Study on the Efficacy and Safety of Intravenous Diltiazem and Metoprolol in Elderly Heart Failure Patients with Rapid Atrial Fibrillation

Aim To evaluate the efficacy and safety of intravenous diltiazem and metoprolol for treatment of rapid ventricular rate in elderly heart failure (HF) patients with rapid atrial fibrillation. Methods A single-blind, randomized study on 72 elderly HF patients with rapid atrial fibrillation was conducted by comparing intravenous diltiazem and metoprolol. Results The efficacy was 94.6% in the diltiazem group,and the ventricular rate decreased from 149±26 bpm to 97±19 bpm, with a mean decrease by 35% 120 min after treatment;Simultaneously, the efficacacy was 97.1% in the metoprolol group,and the ventricular rate decreased from 150±27 bpm to 95±18 bpm, with a mean decrease by 35%. 3 and 2 patients developed asymptomatic hypotension respectively. No patient developed worsening of HF due to diltiazem, but one patient developed worsening of HF in metoprolol group. Conclusions Diltiazem and metoprolol are all efficacious and relatively safe to control the rapid ventricular rate in elderly HF patients with rapid atrial fibrillation.