索他洛尔和普罗帕酮对心律失常患者QT离散度的影响及临床效果对比研究

Study on QT Dispersion and Clinical Effects of Sotalol and Propafenone on Patients with Arrhythmia

目的比较索他洛尔和普罗帕酮对心律失常患者治疗前、后QT离散度（QTd）变化的影响及临床效果差异。方法 60例心律失常患者随机分为索他洛尔组30例和普罗帕酮组30例,索他洛尔组单独给予索他洛尔,起始剂量40mg/次,2次/d,治疗1周后如无效可逐步增加剂量,单次剂量增加40 mg/次,最大量不超过120 mg/次,2次/d。普罗帕酮组患者均单独使用普罗帕酮,起始剂量150 mg/次,3次/d,如疗效不佳则每隔5~7 d增加单次剂量50 mg,最大剂量不超过900 mg/d。2组治疗时间均为7周。治疗期间不合用其他抗心律失常药物。结果索他洛尔和普罗帕酮两组治疗显效率分别为80%与70%,索他洛尔组较普罗帕酮组疗效稍好,但差异无统计学意义（P〉0.05）。索他洛尔组治疗后QT间期、QTd较治疗前差异有统计学意义（P〈0.05）,普罗帕酮组QT间期及QTd用药前、后差异无统计学意义（P〉0.05）。索他洛尔和普罗帕酮组治疗后的QT间期及QT离散度差异有显著性意义（P〈0.05）。结论索他洛尔可引起QTd的降低,是其疗效较普罗帕酮好的重要因素。

Objective To compare the clinical effect and QT dispersion of sotalol and propafenone before and after drug treatment in patients with arrhythmia. Methods Sixty cases of arrhythmia were randomly divided into sotalol group and propafenone group.Sotalol group started from a dose at 40 mg per time,2 times per day,if invalid one week after treatment we gradually increased the dosage with an increased single dose at 40 mg/time,the most massive dosage no more than 120 mg/time,2 times per day.Propafenone group was treated with propafenone alone,starting with a dose at 150 mg/time,three times a day,with a single increased dose 7 days after first drug administration.Maximum dosage was 900 mg/d.The treatment lasted seven weeks.During the treatment,no other anti-arrhythmic drugs were given. Results The effective rates of sotalol and propafenone groups were 80% and 70%,respectively.No statistically significant difference was found between the two groups（P0.05）.Sotalol group showed significant difference in QTd before and after drug administration（P0.05）,while propafenone group showed no significant difference in QTd before and after drug administration（P0.05）.There was also statistically significant difference in QTd between sotalol and propafenone groups after drug administration（P0.05）. Conclusions Sotalol can cause the reduced QTd,which may be the important factor for better effect compared with propafenone.