常用控制心室率药物的随机对照研究

目的；比较五种常用药物组合对慢性房颤患者静息及活动状态下心室率的控制作用。方法：顺序住院和６０例慢性心房纤颤患者由不参与研究者随机分为五组相比即Ａ组疃 高辛０．２５ｍｇ／ｄ；Ｂ组：单用倍它乐克５０ｍｇ／ｄ；Ｃ组：单用异搏定（缓释制剂）２４０ｍｇ／ｄ；Ｄ组：０．２５ｍｇ地高辛与５０ｍｇ倍它乐克联用；Ｅ组：０．２５ｍｇ地高辛与２４０ｍｇ异搏定（缓释剂）联用。每组１２例。统计处理用ＡＮＯＶＡ、非参数统计

VENTRICULAR RATE CONTROL IN CHRONIC ATRIAL FIBRILLATION: A RANDOM STUDY OF FIVE DRUG REGIMENS

Objective: We compared the effects of five pharmacologic regimens on the rest and exercise-induced changes of ventricular rate (VR) of patients with chronic atrial fibrillation (CAF). Methods: In 60 patients (27 male, 45.05 10.89 yr) with CAF, the effects in VR by 5 standardized daily regimens: Group A: 0.25 mg/d Digoxin, Group B: 50 mg/d Betaloc, Group C: 240 mg/d Verapamil-SR, Group D: 0.25 mg Digoxin 50 mg Betaloc and Group E: 0.25 mg Digoxin 240 mg Verapamil-SR, were studied in random order. All data were analyzed by ANOVA, non-parameters test, Chi-square Test and paired t test, respectively. Results: The VR on digoxin Betaloc was significantly lower than that on digoxin ( P =0.000), Betaloc ( P =0.002) and verapamil-SR ( P =0.002). During exercise, digoxin and digoxin Betaloc treatment resulted in the highest and lowest mean VR respectively. In the group D, the object VR time is shortest, and the group A is longest. Compared with other group, the average hospital time is shortest in the group D, but significant difference show only compare with group A or group B. Heart function is improvement in all groups, but no significance ( P >0.05). Conclusions: This study indicates as single agents, digoxin is least effective for controlling ventricular rate in atrial fibrillation during rest or activity. For the Betaloc and verapamil, the effective for controlling VR are same. Digoxin Betaloc produced the most effective rate control reflecting a synergistic effect on the AV node.