胺碘酮与毛花苷C治疗快速心房颤动的临床对比研究

目的比较胺碘酮与毛花苷C治疗快速心房颤动的疗效差异。方法选择由各种心脏病引起的80例快速房颤患者,随机分为胺碘酮组(n=40)和毛花苷C组(n=40)。胺碘酮组:给予胺碘酮负荷量150 mg静注后,以0.8~1.0 mg/min维持静脉点滴,依心室率情况调节胺碘酮剂量。毛花苷C组:近1周未用洋地黄者,以毛花苷C 0.4 mg静脉注射;近1周口服地高辛者,以毛花苷C 0.2 mg静脉注射,依疗效情况调节剂量。观察两组复律情况及心室率的变化。结果胺碘酮组与毛花苷C组的有效率分别为82.5%(33/40)和57.5%(23/40),两组比较有显著性差异(P<0.05);平均起效时间分别为(14.2±10.3)min和(30.5±5.1)min,两组比较有显著性差异(P<0.01)。结论静脉注射胺碘酮治疗快速房颤心室率,作用迅速、安全有效,不影响心功能,维持时间长,临床可作为急诊控制快速房颤心室率的首选药物之一。

Comparative study on the efficacy of amiodarone and lanatoside C for the treatment of rapid atrial fibrillation

Objective To compare the efficacy of amiodarone and lanatoside C for the treatment of rapid atrial fibrillation.Methods Eighty patients with rapid atrial fibrillation were randomly divided into two groups:amiodarone group(n=40) and lanatoside C group(n=40).Amiodarone group was treated with amiodarone intravenous injection with the loading dosage of 150 mg and followed by intravenous infusion at the rate of 0.8～1.0 mg/min with an adjustable dose depending on ventricular rate.For lanatoside C group,patients free from digitalis usage within recent one week were intravenously injected with lanatoside C 0.4 mg,while those with a history of oral digitalis usage within recent one week were treated similarly(0.2 mg) and the dose was adjustable according to therapeutic effect.Results The effective rate was 82.5%(33/40) in the amiodarone group and 57.5%(23/40) in the lanatoside C group with a significant difference between the two groups(P<0.05).Amiodarone group showed a significantly shorter onset time of antiarrhythmic effect as compared with lanatoside C group (14.2±10.3) min vs.(30.5±5.1) min,P<0.01].Conclusion Intravenous amiodarone for the treatment of rapid atrial fibrillation,characterized by rapid onset,safety and effectiveness,no interference to cardiac function and long therapeutic duration,is one of the choices for controlling rapid ventricular rate during atrial fibrillation under emergency condition.