艾司洛尔与毛花苷控制快速心房颤动患者心室率的短时疗效比较

目的比较静脉应用艾司洛尔与毛花苷控制快速心房颤动患者心室率的短时疗效和安全性。方法60例快速心房颤动患者，心室率≥120次／min，随机分为艾司洛尔组、毛花苷组各30例。艾司洛尔组首次剂量给予0．5mg／kg，1min静注，观察5min，若心室率〉100次／min或下降〈20％，则追加0．5mg／kg，同时以0．05mg·kg-1·min-1微量泵起始维持，维持量最大可加至0.3mg·kg-1·min-1，若血压〈90／60mmHg，则停止试验。毛花苷组首次剂量给予毛花苷0．4mg或0．2mg缓慢静注，若心室率〉100次／min或下降〈20％，可追加0．2mg。观察两组用药后5min、10min、30min、60min、90min和120min心率、血压及临床表现；同时记录用药后药物起效时间及不良反应。结果两组患者用药后不同时刻的心室率均明显降低，与用药前比较差异均有统计学意义，用药2h后艾司洛尔组心室率下降幅度大于毛花苷组（P〈0．05）；艾司洛尔和毛花苷组平均起效时间分别为（6．4±3．8）min和（43．1±12．6）min，两者差异具有统计学意义（P〈0．01）。艾司洛尔和毛花苷组总有效率分别为86．3％和83．3％（P〉0．05），无统计学意义；两组不良反应发生率无统计学意义。结论静脉应用艾司洛尔控制快速心房颤动患者心室率的短时疗效显著，安全性好。

A short-term clinical observation of intravenous esmolol and lanatoside in the treatment of rapid ventricular rate in patients with atrial fibrillation

Objective To evaluate the short-term efficiency of intravenous esmolol and lanatoside for the treatment of rapid ventricular rate in patients with atrial fibrillation. Methods Sixty patients with atrial fibrillation （ventricular rate ≥120 beats/minute） were randomly divided into two groups.The two groups were intravenously administered esmolol and lanatoside respectively. Heart rate and the mean response time were measured after the treatment. Adverse effects were recorded. Results Ventricular rate decreased significant in different time after treatment in two groups, but more significantly in esmolol group. The mean response time was （6.4±3.8） minutes and （43.1±12.6）minutes in esmolol and lanatoside groups respectively. No significantly changes of the total effective rate on controlling rapid atrial fibrillation were found between two groups （86.7% in esmolol group versus 83.3% in lanatoside group）. Conclusion Intravenous esmolol is efficient, rapid and safe to treat rapid ventricular rate in patients with atrial fibrillation.