【摘要】 目的　观察静脉注射地尔硫卓、胺碘酮及西地兰控制快速房颤心室率的疗效及安全性。方法　将 73例快速房颤的患者 ,采用随机方式分为地尔硫卓组 ( 2 5例 ) ,以 0 .2 5 kg加液体 2 0ml静脉注射 ,观察 2 0分钟 ,如无效重复用药 1次 ;胺碘酮组 ( 2 4例 ) ,以 15 0mg加液体 2 0ml静脉注射 ,10分钟注入 ,继以 0 .8-1.0mg min静脉滴注维持 ;西地兰组 ( 2 4例 )作为对照组 ,以西地兰 0 .2 -0 .4mg稀释后静脉注射 ,如无效可灼情追加 0 .2 -0 .4mg,总量 0 .4-1.0mg。结果　地尔硫卓、胺碘酮及西地兰控制房颤的快速心率总有效率分别为 :92 %、93 %、72 % ,心室率下降幅度分别为 3 5 %、3 3 %和 2 4% ,平均起效时间分别为 ( 7.9± 3 .7)分钟、( 14 .1± 8.7)分钟、( 3 3 .1± 10 .3 )分钟 ,发生复律分别为 1例、4例、1例 ;地尔硫卓组出现低血压 3例 ,窦缓 1例 ;胺碘酮组窦缓 1例 ;西地兰组低血压 1例 ,均自行缓解 ,未发生心衰加重。结论　与西地兰比较 ,静脉注射地尔硫卓及胺碘酮均能安全有效地控制心室率 ,但地尔硫卓更迅速 ,而胺碘酮相对安全。更多还原

【Abstract】 Objective To evaluate the efficacy and safety of intravenous diltiazem,amiodarone and cediland for treatment of rapid ventricular rate in atrial fibrillation.Methods A single-blind,randomized study on 73 patients with rapid atrial fibrillation was conducted by comparing intravenous diltiazem,amiodarone and cediland.25 patients were treated with intravenous diltiazem of the dose on 0.25mg/kg in 20ml solution,and observed for 20 minutes.If there is no effect on a patient,it must be done again.24 patients were treated with intravenous amiodarone of the dose 150mg in 20ml solution in 10 minutes,after that,with intravenous drop in 0.8-1.0mg/min. 24 patients were treated with intravenous cediland of 0.2mg to 0.4mg after diluted as control group,If non-effectiye,it can be given 0.2-0.4mg again,but the total dose was 0.4-1.0mg.Results The total effective rate were 92%,93% and 72% with a mean decrease in heart rate by 35%,33% and 24% of the baseline in th diltiazem, amiodarone and cediland group, respectively, while mean time response to the bolus was (7.9±3.7), (14.1±8. 7) and(33.1±10.3)minutes,respectively.Of the 25 patients treated with diltiazem, 1 patient restored to sinus rhythm, 3 patients developed asymptomatic hypotension and 1 patient had sinus bradycardia. Of the 24 patients treated with amiodarone ,4 patients restored to sinus rhythm, 1 patient had sinus bradycardia, Of the 24 patients treated with cediland, 1 patient restored to sinus rhythm and 1 patient developed asymptomatic hypotension. All events were resolved without pharmacologic treatment. No patient developed worsening of congestive heart failure due to diltiazem, amiodarone and cediland.Conclusions Compared with cediland,both diltiazem and amiodarone are safe and effective in acutely slowing of rapid ventricular rate in patients with atrial fibrillation .but diltiazem is more rapid and amiodarone is relatively safe.更多还原