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目的探讨胺碘酮与地尔硫(艹卓)对快速心房颤动(房颠)心室率控制的疗效和安全性。方法64例房颤患者随机分为胺碘酮组和地尔硫(艹卓)组。胺碘酮组33例,接受负荷量150 mg静注后,以0.5～1.0mg/min维持静脉滴注,并据心率变化调节胺碘酮用量;地尔硫(艹卓)组用0.25 mg/kg静注后,无效者120 min重复应用同剂量地尔硫(艹卓)。每隔5 min及每次用药前、后记录心率、血压及临床表现。结果胺碘酮组与地尔硫(艹卓)组控制心室率有效率分别为84.8%和90.3%;平均起效时间分别为(15.1±7.7)min和(8.7±4.1)min。胺碘酮组发生心动过缓2例,对心功能无影响,不良反应发生率6.1%;地尔硫(艹卓)组心动过缓3例,心功能恶化5例,不良反应发生率25.8%,二者比较,差异有统计学意义(P<0.05)。结论胺碘酮控制心室率与地尔硫(艹卓)相比,同样有效。地尔硫(艹卓)起效迅速;但胺碘酮不良反应少。更加安全。
Objective To investigate the efficacy and safety of amiodarone and diltiazem in the control of ventricular rate in patients with rapid atrial fibrillation (AF). Methods 64 patients with atrial fibrillation were randomly divided into amiodarone group and diltiazem group. In the amiodarone group, 33 patients received intravenous infusion of 150 mg at a dose of 0.5-1.0 mg / min, and the amiodarone dosage was adjusted according to the change of heart rate. In the diltiazem group, 0.25 mg / kg after intravenous injection of ineffective 120 min repeat the same dose of diltiazem. Heart rate, blood pressure and clinical manifestations were recorded every 5 minutes and before and after each dose. Results The effective rates of amiodarone group and diltiazem group in controlling ventricular rate were 84.8% and 90.3%, respectively. The average effective time was (15.1 ± 7.7) min and (8.7 ± 4.1) min, respectively. Amiodarone group occurred bradycardia in 2 cases, no effect on heart function, the incidence of adverse reactions 6.1%; diltiazem (艹 Zhuo) group bradycardia in 3 cases, cardiac function deterioration in 5 cases, the incidence of adverse reactions 25.8% , The difference between the two was statistically significant (P <0.05). Conclusions Amiodarone is equally effective in controlling ventricular rate compared with diltiazem. Diltiazem (艹 Zhuo) rapid onset; but less adverse reactions amiodarone. safer.