美托洛尔与毛花苷快速控制心房颤动心室率的比较

Fast effect of intravenous metoprolol on the treatment of rapid ventricular rate in patients with atrial fibrillation

目的:比较静脉应用美托洛尔与毛花(洋地黄)苷快速控制心房颤动患者心室率的疗效和安全性。方法:68例快速心房颤动患者(心室率≥120次/min),随机分为美托洛尔组、毛花苷组各34例。美托洛尔组首次剂量给予5mg缓慢静注,观察15min,若心室率>100次/min或下降<20%,则追加5mg,最多给药10mg,若血压<90/60mmHg,则停止试验;毛花苷组首次剂量给予毛花苷0.4mg或0.2mg缓慢静注,若心室率>100次/min或下降<20%,则追加0.2mg。观察两组用药后10min、30min、60min、90min和120min心率,血压及临床表现;同时记录用药后药物起效时间及不良反应。结果:两组患者用药后2h内的心室率与用药前比较均明显降低(P<0.05),用药2h后美托洛尔组心室率下降幅度大于毛花苷组(P<0.05);美托洛尔、毛花苷组平均起效时间分别为(12.4±6.7)min和(41.6±11.2)min,两者差异有显著性(P<0.01);美托洛尔、毛花苷组总有效率分别为88%和76%无显著性差异(P>0.05);两组不良反应发生率均为12%。结论:静脉应用美托洛尔控制快速心房颤动患者心室率的短时疗效显著,患者安全性好。

Objective： To evaluate the short-term efficacy of intravenous metoprolol and lanatoside on treatment of rapid ventrieular rate in patients with atrial fibrillation （Af）. Methods： Sixty-eight patients with Af （ventrieular rate ≥120 beats/ minute） were randomly divided into two groups. The two groups were intravenously administered metoprolol or lanatoside respectively. Heart rate and the mean response time were measured after the treatment. Adverse effects were recorded. Results： Ventricular rate significantly decreased after treatment in two groups, but the venrricular rate was lower in the motoprolol group than that of the lanatoside group （P〈0.05）. The mean response time was （12.4 ±6, 7） min and （41.6±11.2） min in metoprolol and lanatoside groups respectively. No significantly difference of total effective rate in controlling rapid Af were found between two groups （88% in metoprolol group versus 76% in lanatoside group）. Conclusion： Intravenous metoprolol is efficient, rapid and safe in the treatment of rapid ventricular rate in patients with Af.