摘要
[目的]研究Ⅲ类抗心律失常药物依布利特与胺碘酮转复阵发性心房颤动（房颤） 的有效性及安全性.[方法]入选阵发性房颤患者63例（男32例,女31例）,随机进入依布利特组（n=28）、胺碘酮组（n=35）.前者于10 min内静脉注射依布利特1 mg,如给药结束10 min后仍未转复为窦性心律, 重复前述治疗1次.后者于10 min内静脉注射胺碘酮150 mg,后以1 mg/min维持6 h,再以0.5 mg/min维持18 h,转复后即刻停药.观察给药后房颤的转复率、转复时间、心室率、QTc变化及不良反应.[结果] 依布利特组转复率明显高于胺碘酮组（67.9% vs 40.0%,P=0.028）,转复时间明显短于胺碘酮组[（20.11±11.54） min vs （523.31±277.73） min,P=0.000];伊布利特组10 min、30 min时对心室率和QTc影响大于胺碘酮组（P〈0.05）.胺碘酮组有2例出现轻度低血压,1例胃肠炎,伊布利特组出现2例单形室性心动过速,两组患者不良反应率差异无统计学意义（P〉0.05）.[结论] 伊布利特转复阵发性房颤疗效高于胺碘酮,转复时间短,是一种转复房颤快速、有效的药物,但用药前后必须加强心电监护.
[Objective]To compare the efficacy and safety of class III antiarrhythmic drugs ibutilide vs amiodarone for the cardioversion of paroxysmal atrial fibrillation（AF）. [Methods] A total of 63 paroxysmal AF patients（32 male and 31 female） were selected and randomly divided into ibutilide group（ n =28） and amiodarone group（ n=35）. The ibutilide group received intravenous injection of ling ibutilide within 10min, and if not reverted to sinus rhythm, above the dose repeated. The amiodarone group received intravenous injection of 150mg amiodarone within 10min followed by a dose of lmg/min maintained for 6h, then 0. 5mg/min maintained for 18h. After eadioversion achieved, the drug was stopped immediately. The suceessful rate of cardioversion, cardioversion time, heart rate, the changes of QTc and adverse reactions were observed. [Results] The cardioversion rate of the ibutilide group was significantly higher than that of the amiodarone group（67.90% vs 40.0%, P =0. 028）. The cardioversion time in ibutilide group was shorter than that in amiodarone group （20.11±11.54min vs 523.31±277.73min, P=0. 000）. The influence on heart rate and QTc in the ibutilide group was greater than that in the amiodarone group at 10min and 30rain（ P d0.05）. In amiodarone group, 2 patients had transient hypotension and 1 had gastroenteritis. In ibutilide group, monomorphic ventricular tachyeardia was found in 2 patients. There was no statistical difference in the rate of adverse reactions between two groups（ P 〉0.05）. [Conclusion] Ibutilide for the eardioversion of paroxysmal atrial fibrillation is more effective than amiodarone. It is a rapid and effective medicine of cardioverion. However, strict cardiac monitoring should be strengthened before and after taking medicine.
出处
《医学临床研究》
CAS
2010年第10期1801-1803,共3页
Journal of Clinical Research
基金
广东省科技计划项目（20088030301142）
