普罗帕酮与维拉帕米在房室结折返性心动过速应急药物治疗中的选择应用研究

Curative effect of Propafenone and Verapamil in the treatment of patients with atrioventricular nodal reentrant tachycardia(AVNRT)

目的探讨治疗房室结折返性心动过速(AVNRT)的两种最常用的药物—普罗帕酮与维拉帕米的作用机制与疗效差异,为临床选择用药提供依据。方法采用交互对照方法,对54例入选患者进行回顾性研究。结果统计数据表明,两种药物疗效差异有统计学意义(P<0.05),而这种差异源于其药物的作用机制不同。结论对于房室结折返性心动过速患者,应急药物治疗宜首选维拉帕米;而对于阵发性室上性心动过速(PSVT)患者,在未明确其折返部位的情况下,也应以维拉帕米作为首选药物。普罗帕酮放在第二位为宜。如能确定是房室折返性心动过速,则应首选普罗帕酮。

Objective To explore the mechanism and curative effect of Propafenone and Verapamil in the treatment of AVNRT in order to provide the basis for the choice of the medicines. Methods 54 patients with AVNRT undergoing Propafenone and Verapamil were enrolled in our cross reference study and statistical analysis was carried out. Results There were significant differences in the curative effect of the two medicines （ P 〈 0.05 ）, which relied on their different mechanisms. Conclusion For the patients with AVNRT, Verapamil should be chosen in the first place. Patients with PSVT, before their reentrant points were found, Verapamil should be chosen in the first place too. Propafenone should be chosen in the second place unless atrioventricular reentrant tachycardia（AVRT） has been defined.