奎尼丁联合胺碘酮治疗持续性心房颤动的临床研究

Study of Quinidine combined with amiodarone on cardioversion of persistent atrial fibrillation

目的探讨奎尼丁联合胺碘酮治疗持续性心房颤动的安全性及临床疗效。方法房颤患者65例,随机分为胺碘酮组31例和联合用药组34例进入胺碘酮组每次给胺碘酮0.2 g,每天3次,持续10 d,奎尼丁联合胺碘酮组第1天奎尼丁每2 h 0.2 g,共5次,如未转复窦律,第2天剂量不变,第3天每2 h 0.3 g,共5次;转复窦性心律后奎尼丁改每8 h 0.5 g,重叠应用胺碘酮3 d。药物负荷量期间未转复者应用同步直流电复律。观察复律率、复律时间、Q-T间期。结果奎尼丁联合胺碘酮组较胺碘酮组转复时间短、转复律高,无严重不良反应。结论奎尼丁联合胺碘酮是治疗房颤的一种安全、有效的方法 。

Objective To observe the safety and effect of quinidine combined with amiodarone on cardioversion of persistent atrial fibrillation. Methods 65 cases of persistent atrial fibrillation patients were randomly divided into amiedarone group （ n = 31 ） and quinidine combined with amiedarone group （ n = 34）. In the former group, amiodarone 0. 2 g was taken orally three times everyday as continued for 10 days. In the latter group quinidine 0.2 g was taken orally every 2 hours and for 5 times during one day , and if cardioversion was not successful in the first day , quinidine would be taken in the second day in the same doze. Quinudine 0. 3 g was taken orally every 2 hours and for 5 tims. After the resumption of sinus rhythm change quinidine 0. 2 g would be taken orally combined with amiedarone 0. 5 g every 8 h for 3 days. In both group if drug cardioversion was fail, synchronous direct current cardivoersion would be used. The rate of successful cardioversion, time of stay in hospital and Q -Tc on electrocardiogram were compared between the two groups. Results The time of stay in hospital was shorter and the success rate of cardioversiou was higher in the combined treatment group than in the amiedarone group without serious compilcations. Conclusion Cardioversion of atrial fibrillation by quinidine combined with amiodarone is safe and effective.