胺碘酮治疗心力衰竭伴快速房颤的疗效观察

Effect of Intravenous Amiodarone on Congestive Heart Failure Patients with Rapid Atrial Fibrillation

目的观察静脉应用胺碘酮治疗充血性心力衰竭(CHF)伴快速心房颤动(Af)患者的短时疗效。方法76例CHF伴快速Af患者,心功能级Ⅱ～Ⅳ级(NYHA),随机分为胺碘酮组、毛花苷组,每组38例,在常规治疗的基础上,胺碘酮组首次剂量给予胺碘酮150mg缓慢静注,随后0.5～1.0mg/min微量泵维持;毛花苷组首次剂量给予去乙酰毛花苷0.4mg或0.2mg缓慢静注,1h后无效者追加0.2mg。观察用药后临床疗效、心电图改善及不良反应。结果两组患者用药后临床疗效比较差异无统计学意义(P>0.05),胺碘酮组与毛花苷组心电图改善比较差异有统计学意义(P<0.05),两组不良反应发生率分别为13.16%和10.52%。结论静脉应用胺碘酮治疗CHF伴快速Af短时疗效显著,患者不良反应较少。

Objective To evaluate the effect of intravenous amiodarone on patients with rapid atrial fibrillation （Af） and congestive heart failure（CHF）. Methods Seventy-six patients with Af and CHF（ NYHA class Ⅱ -Ⅳ ） were randomly divided into two groups. ①amiodarone group（ n = 38 ）：the loading dosage of amiodarone 150 mg followed with 1.5 mg/min; ②lanatoside group （ n = 38 ） ： the loading dosage of lanatoside 0. 4 mg or 0.2 rag, more 0. 2 mg should be medicated if no effect occur one hour later. The clinical curative effect,the cardiogram improve and the adverse effect were recorded after medicating. Results There were no significant difference on clinical curative effect after medication between two groups （ P 〉 0.05 ）. There were significant difference on cardiogram improve between amiodarone group and lanatoside group （ P 〈 0. 05 ）. The adverse effects were without statistic difference in two groups （ 13.16% in amiodarone group and and 10.52% in lanatoside group）. Conclusion It is of safety and rapid-effect for amiodarone in controlling the rapid ventricular rate in patients with Af and CHF.