地尔硫与西地兰联合静脉应用控制快速性房颤心室率的疗效

Efficacy of diltiazem combined with cedilanid intravenously for ventricular rate control in atrial fibrillation

目的比较地尔硫与西地兰联合静脉应用与地尔硫单独静脉应用对房颤快速心室率的控制。方法收集我院心内科2008年1-9月房颤伴快速心室率患者50例,将患者随机分为地尔硫与西地兰联合静脉应用组(A组)及地尔硫单独静脉应用组(B组),每组各25例患者。A组与B组均先给予地尔硫0.25mg/kg静脉推注,继以10mg/h持续静脉泵入,观察15min后,如心率大于100次/min,再次给予地尔硫0.25mg/kg静脉推注。A组于首次应用地尔硫时,给予西地兰0.4mg静脉推注。结果用药过程中,A组5例、B组3例患者转为窦性心律。A组进入评价的20例有效17例(85%),B组进入评价的22例有效11例(50%)。A组有效率高于B组(P<0.05)。结论地尔硫与西地兰联合静脉应用控制房颤快速心室率的效果优于地尔硫单独静脉应用。

Objective To evaluate the efficacy of diltiazem combined with cedilanid vs diltiazem alone for ventricular rate control in patients with atrial fibrillation. Methods 50 patients with atrial fibrillation and rapid ventricular rates were randomized to 2 groups,25 patients for each group, Group A was given diltiazem combined with cedilanid;group B was given diltiazem alone; Both groups were administrated with diltiazem（0.25 mg/kg, iv） and followed by continuous administration of diltiazem intravenously（ 10 mg/h） ; After 15rain of observation, a second dose of diltiazem（0.25 mg/kg,iv） was given if the heart rate was still more than 100 beats per minute （bpm）. In group A,the ftrst dose of diltiazem was combined with 0.4 mg cedilanid. The successful rate control was defined as a ventricular rate 〈 100 bpm persisting for 10 minutes. Results During the administration, the sinai rhythm was regained for 5 patients in group A,and 3 patients in group B（ who were ruled out of the study）. The successful heart rate control was observed in 17 patients of group A （ 85 % ） and 11 patients of group B （ 50% ）. The rate of ventricular rate control in group A was higher than that in group B （ P 〈 0.05 ）. Conclusion The efficacy of diltiazem combined with cedilanid intravenously is better than diltiazem alone in patients with atrial fibrillation and a rapid ventricular rate.