艾司洛尔静脉注射控制房颤患者快速心室率的临床研究

Clinical study of rapid control of fast ventricular rate with intravenous esmolol in patients with atrial fibrillation

目的：评价艾司洛尔静脉注射控制快速房颤患者心室率的有效性和安全性。方法：选择４７例符合入选标准的快速房颤患者，随机分为艾司洛尔治疗组（２７例）和西地兰治疗组（２１）例，分别给予文司洛尔ｌｍｇ／Ｋｇ或西地兰０．０８ ｍｇ／Ｋｇ静脉注谢，于静注前、静往后不同时刻观察患者心率、血压、临床表现的改变。结果：与西地兰组比较，艾司洛尔起效快（０ ６５± ０．１５ｖｓ３９±９．１３， Ｐ＜０．００１）、降低心室率的作用明显（２５．９±０．０６ｖｓ １９．９±０．０９， Ｐ＜０．００１），有效率高（１００％ ｖｓ ７０％ Ｐ＜０．００１），但疗效持续时间短（８．１２±４．０５ ｖｓ １３５±２８．２２ Ｐ＜０．００１），而西地兰静注后血压无显著变化。全部患者病情改善，无毒副反应发生。结论：艾司洛尔静脉注谢控制快速房颤患者心室率快速有效，安全可靠。

Objectives To evaluate the safety and efficacy of intravenous esmolol in patients with atrial fibrillation. Methods 47 eligible patients were randomly divided into esmolol group(n = 26, esmolol 1mg/ Kg iv injection for 1 minute) and cedilanid group(n = 21, cedilanid 0.08 mg/ Kg tv in- jection for 1 minute). Then the changes of heart rate, blood pressure and clinical manifestation at different time points were observed. Results Compared with the cedilanid group, esmolol took effect faster (0.65 ± 15 vs 39 ± 9. 13 P <0. 001), decreased ventrcular rate much more(25. 9 ± 0. 06 vs 19. 9 ± 0. 08 P<0.00l) and had a higer effect rate (100% vs 71 % P < 0.001 ), but its effect time was shorter (8.12 ± 4. 05 vs 135 ± 28. 22 P <0. 001). In addition, esmolol decreased blood pressure significantly, this effect was obviously at 6 minutes after tv injection. But cedilanid had not this effect. All patients improved without any toxious and side effect. Conclusion intravenous injection of esmolol is safe and efficacious to the control of rapid ventrcular response in patients with atrial fibrillation.