胺碘酮与普罗帕酮用于房颤转复与维持窦性心律的临床观察

目的观察应用胺碘酮与普罗帕酮对阵发性快速心房颤动的治疗效果。方法选择144例患者按就诊先后顺序随机分为二组，胺碘酮组（74例）给予胺碘酮注射液负荷量150mg静脉推注10min注射完毕．观察10min未恢复窦性心律或心率仍较快者以0．5～1mg／min维持静脉滴注。复律成功后给予胺碘酮片口服维持窦性心律。普罗帕酮组（70例）给予普罗帕酮注射液70mg静脉推注10min注射完毕，观察10min未恢复窦性心律，重复应用，最大累计量为210mg，复律成功后给予普罗帕酮片口服维持窦性心律。结果胺碘酮组复律疗效及维持窦性心律疗效均优于普罗帕酮组（P〈0．05），治疗1、3、6、12个月后胺碘酮组左心房直径渐缩小，E、A及E／A渐提高，使E／A倒置得到恢复。结论胺碘酮和普罗帕酮对阵发性快速房颤均有较高的转复率，胺碘酮复律后窦性心律维持率高于普罗帕酮，胺碘酮对逆转心房心肌重构安全有效。

Clinical observation on amiodarone and propafenone for rehabilitation and maintenance of sinus rhythm of atrial fibrillation

Objective To evaluate the effect of amiodarone and propafenone on paroxysmal atrial fibrillation. Methods A total of 144 patients with paroxysmal atrial fibrillation were randomly divided into two groups. Group A （74 cases） received amiodarone injection （150 mg pushing injection, being finished in 10 minutes, and after 10 minutes, if no resumption of sinus rhythm or heart rate being still fast, 0.5-1 mg/min of intravenous drip）. After the successful conversion of sinus rhythm, oral amiodarone tablets were given to maintain the sinus rhythm. Group B （70 cases） received propafenone injection （70 wg pushing injection in 10 minutes, and after 10 minutes＇ ohservation, if no restoration of sinus rhythm, repeating the same, and the largest cumulative dose being 210 mg）. After the suecessful conversion of sinus rhythm, oral propafenone tablets were given. Results The therapeutic effects （conversion and maintenance of the sinus rhythm） of amiodarone （Group A） were better than those of propefenone （Group B）, P 〈 0.05. In Group A, 1, 3, 6, 12 months after the treatment, the left atrial diameter gradually narrowed, and E, A and E/A gradually improved so that the E/A invertion was restored. Conclusions Both amiodarone and propafenone have the efficency in the treatment of paroxysmal atrial fibrillation （high rapid conversion rate）. Amiodarone has higher maintenance rate of sinus rhythm than propafenone, and amiodarone also has the effect on atrial reversal myocardial remodelingg safely.