静脉注射伊布利特转复心房颤动或心房扑动的临床分析

Effects of intravenous ibulilide on atrial fibrillation and atrial flutter

目的观察伊布利特注射液转复持续时间〈90d的心房颤动（简称房颤）、心房扑动（简称房扑）的有效性及安全性。方法选择心电图确诊为房颤、房扑，心室率≥60次／min且发作在90d以内的患者共52例，随机分为普罗帕酮组和伊布利特组，每组均为26例。伊布利特组：体重≥60kg者，首次静脉推注伊布利特注射液1mg；停用药后10min仍为房颤或房扑，再次静脉推注1mg。体重〈60kg者，首次0．01mg／kg静脉推注；停用药后10min仍为房颤或房扑，再次静脉给予0．01mg／kg，中途转复则立即停用。普罗帕酮组首次70mg静脉推注普罗帕酮，如无效，10min后再给予35mg，中途转复则立即停用。结果2组均能有效降低房颤或房扑的心室率，伊布利特组房颤、房扑的转复率明显高于普罗帕酮组，差异有统计学意义（65％对比42％，P〈0．01）。2组平均转复时间相比，伊布利特组明显短于普罗帕酮组，差异有统计学意义（P〈0．01）。伊布利特组3例出现短阵室性心动过速，普罗帕酮组2例出现低血压。结论伊布利特是一种起效快，对房扑、房颤患者转复率高的新型抗心律失常药物，与普罗帕酮比较，伊布利特对房扑、房颤的转复有明显的优势。

Objective To evaluate the efficacy and safety of ibutilide for cardioversion of atrial fibrillation （AF） and atrial flutter（AFL）. Methods A total of 52 patients with Atrial fibrillation or atrial flutter less than 90 days, were randomly divided into ibutilide group and propafenone group. Patients in ibutilide group received 1 mg ihatilide when body weight equal to or higher than 60 kg or 0.01 mg per kg when body weight lower than 60 kg; treatment was repeated if atrial fibrillation or flutter was not converted into sinus rhythm 10 minutes after the first dosage. Patients in propafenone group received 70 mg propafenone, followed by a following 35 mg if atrial fibrillation or flutter persisted 10 rain after the first dosage. Results Both ibutilide and propafenone could reduce ventricle rate. But AF or AFL conversion rate in ibutilide group was 65% ,significantly higher than that in propafenone group （42% ,P 〈 0.01 ）. Conversion time in ihatilide group was significantly shorter that that in propafenone group （ P 〈 0.01 ）. Torsade de peintes occurred in 3 patients in ibutilide group ibutilide, and 2 patients had transient hypotension in propafenone group. Conclusion Compared with propafenone, Ibutilide has rapid and good effect on conversion for atrial fibrillation and atrial flutter.