静脉注射不同剂量盐酸地尔硫卓治疗快室率心房纤颤的观察

目的:探讨静脉应用不同剂量地尔硫卓治疗快速心房纤颤的临床疗效和安全性。方法:100例快速心房纤颤(排除预激综合征合并房颤)患者,设对照组(18例),研究组按地尔硫卓0.05mg/kg(20例)、0.15mg/kg(22例)、0.25mg/kg(22例)、0.35mg/kg(18例)四种不同剂量于3min内静脉注射,观察用药时、后患者心率、血压、心电图及临床症状。结果:不同剂量地尔硫卓对快速心房纤颤作用随剂量增加而增大,以0.25mg/kg显效率最大(90.9%),较0.05mg/kg组、0.15mg/kg组显著(P分别<0.01,<0.05),且起效时间短,临床症状明显改善(P<0.01);血压随剂量增加而逐渐下降。未发生严重副作用,无一例发生房室传导阻滞和窦性停搏。结论:静脉注射地尔硫卓可以迅速控制心房纤颤的心室率,疗效以0.25mk/kg为最佳,安全可靠。

Effect of different dosage of intravenous diltiazem on atrial fibrillation with rapid ventricular rate

Objective:To evaluates the efficacy and safety of different dosage of intravenous diltiazem on atrial fibrillation with rapid ventricular rate.Methods:One hundred patients with atrial fibrillation with rapid ventricular rate were randomly divided into four dosage groups(0.05mg/kg with 20 cases,0.15mg/kg with 22 cases,0.25mg/kg with 22 cases,and 0.35mg/kg with 18 cases,respectively) and control group(n=18).Heart rate,blood pressure,ECG and clinical presentation were all observed.Results:Better efficacy was found in greater dosage group,especially in the group treated with 0.25mg/kg dosage,there were about 91% patients with good response,No patient developed with atrioventricular block or sinus arrest.Conclusion:Intravenous diltiazem with dosage of 0.25mg/kg possesses best effective and it is safely for slowing the ventricular rate in patients with atrial fibrillation.