快速性心房颤动的急诊治疗附182例临床分析

Emergency Treatment of Rapid Atrial Fibrillation and Retrospective Analysis of 182 Cases

目的:观察和比较静脉注射地尔硫、毛花甙C、胺碘酮、普罗帕酮及美托洛尔控制快速心房颤动(AF)心室率的即时疗效及安全性。方法:对2003～2005年在我院急诊就诊的182例快速AF患者,进行回顾性分析,分别区分为静脉注射地尔硫组、毛花甙C组、胺碘酮组、普罗帕酮组及美托洛尔组,观察每组治疗前后的心率、降低心室率的达标率、恢复赛性心率的例数及不良反应发生率。结果:5组控制AF快速心室率的达标率分别为94.7%、44.0%、68.3%、65.6%和85.7%。5组病人在治疗开始后第60分钟恢复窦性心律的情况无明显差别,不良反应的发生率在普罗帕酮组和美托洛尔组较高。结论:静脉注射地尔硫能迅速、安全、有效地控制AF的快速心室率:毛花甙C和胺碘酮安全性良好但对心室律的控制程度较差;普罗帕酮和美托洛尔不良反应多,安全性差。

Objective： To investigate and compare the effect and safety of intravenous Diltiazem, lanatoside C, Amiodarone, Propafenone and Metoprolol for rapid atrial fibrillation. Methods： The 182 cases received to the Emergency Department were divided to Diltiazem, Lanatoside C, Amiodarone（C）, Propafenone and Metoprolol group. For every group, the heart rate before and after treatment, sinus rate recovery and adverse effects were investigated. Results： The satisfactory control rate of ventricular rate for Diltiazem, Lanatoside C, Amiodarone（C）, Propafenone and Metoprolol group is respectively 94.7%A4.0 %,68.3%,65.6% and 85.7% after 60 minutes. There is no difference in sinus rate recovery among all groups. The incidence of adverse effects is high in Propafenone and Metoprolol group. Conclusions： Diltiazem could control ventricular rate rapidly, safely and effectively in patients with rapid atrial fibrillation. Lanatoside C and Amiodarone group is safe but the degree of ventricutar rate controlling is insufficient. Propafenone and Metoprolol group have more adverse effects and poor safety.