小剂量氨茶碱治疗缓慢室率性房颤的长期疗效观察

Long term effects of small dose aminophylline in aged patients with atrial fibrillation with a slow ventricular response

目的研究小剂量氨茶碱对老年缓慢心室率性心房纤颤的长期疗效。方法１５例有症状的老年缓慢心室率性房颤病人口服氨茶碱（１５０ｍｇ／ｄ）。治疗前及治疗后第７天、第１、３、６、９及１２个月行心电图及动态心电图检查。结果以均数±标准差表示，采用秩和检验分析差异显著性。结果治疗后第７天静息心率、２４小时平均心率、最慢心率及最快心率分别增加３８％（Ｐ＜０．０１）、２８％（Ｐ＜０．０１）、２６％（Ｐ＜０．０５）及１６％（Ｐ＜０．０１），２４小时＞２５００ｍｓ的心脏停搏次数减少９４％（Ｐ＜０．０１），室性早搏次数增加６％，但差异不显著。随访１２个月（中位数），各项参数与治疗后第７天的结果相似，临床症状明显减轻或消失。结论小剂量氨茶碱治疗老年缓慢心室率性房颤有效。

Objective To study the long term effects of small dose aminophylline in aged patients suffering from atrial fibrillation with a slow ventricular response. Methods In 15 patients (aged 66 6±4 2 years) with symptomatic atrial fibrillation and a slow ventricular response, a resting electrocardiogram and 24 hour Holter recording were obtained before and 7 days, 1 month, 3 months, 6 months, 9 months as well as 12 months after the administration of aminophylline( 150 mg/day in 3 divided doses). Data were expressed as ±s and rank sum test was used in data analysis. Results At the 7 days evaluation, aminophylline significantly increased the resting heart rate (HR) by 38% ( P <0 01),the mean 24 hour HR by 28% ( P <0 01),the minimal 24 hour HR by 26% ( P <0 01) and the maximal 24 hour HR by 16% ( P <0 01).Cardiac pauses >2 500 ms were markedly decreased by 94% ( P <0 01). The daily number of ventricular premature beats increased by 6%,but not significantly different ( P <0 05).During the follow up period (12±3 78 months), all the parameters were similar to those observed at the 7 day evaluation. The symptoms related to slow ventricular response were markedly reduced or disappeared. Conclusions The data suggest that small dose aminophylline is a effective therapy in aged patients with symptomatic atrial fibrillation with a slow ventricular response.