胺碘酮不同给药途径对阵发性心房颤动患者的疗效及安全性

Safety and efficacy of different ways of amiodarone administration for treatment of paroxysmal atrial fibrillation

目的观察胺碘酮不同给药途径对阵发性心房颤动(简称房颤)的疗效及安全性。方法128例阵发性房颤患者随机分成两组,A组:胺碘酮5mg/kg静脉注射15min,接着以1.5mg/min的速度静脉滴注6h,再以0.7～1mg/min静脉滴注24～48h,同时口服胺碘酮200mg/d。B组:胺碘酮600mg/d。给药后心电及血压监测48h。比较两组转复时间及24h,48h,7天,1个月的转复率。结果两组房颤转复率没有差别(P>0.05)。A组的房颤转复时间明显缩短(734±128minvs1428±242min,P<0.05)。给药后7天、1个月两组未转复仍保持房颤患者的心室率明显降低(P<0.05)。A组的血压在给药后24h内明显下降,而B组的血压一直保持稳定。A组有5例浅静脉炎。结论胺碘酮静脉给药可显著缩短房颤的转复时间,但增加低血压及浅静脉炎的风险。

Objective To investigate the safety and efficacy of different ways of amiodarone administration for treatment of paroxysmal atrial fibrillation （AF）. Methods The study population consisted of 128 patients with paroxysmal AF, which was divided as group A ： 5 mg/kg over 15 min followed by 1.5 mg/min over the next 6 h, by 0.7 - 1 mg/min over 24 - 48 h, at the same time oral amiodarone 200 mg per day and group B： oral amiodarone 600 mg per day. The ECG and blood pressure of all patients were monitored for 48 h. Results Conversion rate of AF was no differences（ P 〉 0. 05 ）. Mean time of cardioversion was 734 - 128 min in group A and was 1 428 - 242 min in group B （ P 〈 0. 05 ）. The heart rate of remaining AF was significantly decreased after treatment 7 clays and 1 month（ P 〈 0. 05 ）. However, blood pressure （BP） in group B remained stable for the observation period, whereas it fell significantly in group A. 5 patients in group A developed superficial phlebitis. Conclusion Intravenous amiodarone acts quicker than its oral form, but increases the risk of hypotension and superficial phlebitis.