【摘要】 目的:观察应用胺碘酮与心律平对阵发性快速心房颤动(房颤)的治疗效果。方法:选择96例患者按就诊顺序随机分为两组,A组(49例):胺碘酮150mg+生理盐水10ml静脉注射,10min注射完毕;B组(47例):心律平70mg+生理盐水10ml静脉注射,5～10min注射完毕。观察10～20min若未转复可重复应用,最大累积量胺碘酮为450mg,心律平为210mg。A组复律成功者继续服用胺碘酮0.2g,每天1次维持。B组复律成功者继续接受心律平治疗,150mg,每8小时1次维持,结果:转复率:胺碘酮组75.51%(37/49),心律平组48.94%(23/47),两组转复率比较有显著性差异(χ2=6.14,P<0.05)。复律后维持窦律的疗效:胺碘酮组的维持率均明显高于心律平组,且两组相比均有显著性差异。随访1,3,6,12月胺碘酮组左心房直径缩小,左心室舒张早期经二尖瓣血流的最高值(E峰值)和左心房收缩时经二尖瓣血流的最大值(A峰值)、E/A增大。1,3,6,12月间比较极有显著性差异(P<0.01)。结论:胺碘酮和心律平对阵发性快速房颤均有较高的转复率,胺碘酮复律后窦律维持率高于心律平,胺碘酮对逆转心房心肌重构安全有效。更多还原

【Abstract】 Objective: To evaluate the efficacy of intravenous amiodarone and propafenon for atriarl fibrillation(AF).Methods: 96 patients were divided into two groups randomly. Group A (49 patients) was treated intravenously with 150 mg amiodarone and 10ml normal saline within 10min.Group B(47 patients) was treated intravenously with 70mg propafenon and 10ml normal saline within 5～10 min. After 10～20 min, when the resuscitation was not good, the above intravenous injections were given again, the maximum accumulated dose was 450mg(AM) and 210mg (propafenon).The patients resuscitated in group A were given amiodarone 0.2g per day. People resuscitated in group B were given propafenon 150 mg every 8 hours.Results: The resuscitation rate of 2 groups was 75.51% (37 /49) and 48.94% (23/47) respectively(χ2 =6.14, P<0.05). At 12 month after treatment period, there was a significant higher sinus rhythm ratio in amiodarone than in propafenone group (P<0.01). There were a smaller left atrial diameter, a higher peak value of blood flow via mitral valve at early left ventricular diastole period (E value) , a higher peak value of blood flow via mitral valve at left atrial diastole period (A value) and a higher E/A ratio at 1,3, 6 and 12 month after treatment period than before treatment in amiodarone group ,with a significant difference between any two different timepoints (P<0.01). Conclusions: Both amiodarone and propafenon have high efficacy for treatment of AF, but amiodarone is better in reversion of atrial remodeling.更多还原