胺碘酮不同给药途径治疗非瓣膜病快心室率房颤的疗效

Effects of two different routes of administration of amiodarone to treat fast ventricular rate in nonvalvular atrial fibrillation patients

目的本研究主要观察胺碘酮静脉(急性)和口服(慢性)两种不同给药途径治疗非瓣膜病快心室率房颤的临床效果及安全性。方法 156例非瓣膜病快心室率房颤患者随机分为两组,A组82例,先用胺碘酮5μg/kg静脉注射15min(负荷量),接着以1～1.5mg/min的速度静脉滴注,维持24～48h,同时口服胺碘酮200mg/d;B组74例,口服胺碘酮600mg/d。给药后持续心电及血压监测,每日记录心电图变化,观察2组间转复时间及24h、48h、1周、1月的转复率。结果两组的房颤转复率没有差别(P>0.05),但A组的房颤转复时间明显缩短(P<0.05)。给药后1周、1月两组均未转律仍保持房颤的患者心室率明显降低(P<0.05)。A组有2例浅静脉炎。两组患者在用药后血压一直保持稳定。结论胺碘酮可有效地治疗非瓣膜病快心室率房颤,静脉用药可显著缩短房颤的转复时间,有效降低心室率,安全可靠。

Objective To observe the clinical efficacy and safety of two different routes of administration （ intravenous and oral）of amiodarone to treat fast ventricular rate in nonvalvular atrial fibrillation patients. Methods 156 patients having rapid ventricular rate nonvalvular atrial fibrillation were randomly divided into two groups. Group A, 82 patients, were given with 5ug/kg of amiodarone intravenously for 15 min （loading dose） initially,and then the continuous infusion in the rate of 1-1.5 mg / min for 24-48h of a total of 200 mg amiodarone. On the other hand, group B of 74 patients were given with 600 mg/d of oral amiodarone. ECG and blood pressure were constantly monitored to observe cardioversion time of 2 groups as well as cardioversion rate in 24h, 48h, 1 week and lmonth. Results No difference of eardioversion rate between two groups was found （P〉0.05）, but much less time of cardioversion was needed in group A （P〈0.05）. From 1 week to a month after the drugs administration, heart rates of patients whose atrial fibrillation remained went significantly lower （P〈0.05）. 2 patients in group A were found of phlebitis. The blood pressure of two groups of patients remained stablely after the treatment. Conelusion It is found that amiodarone is an effective treatment of non-valvular atrial fibrillation,the intravenous administration of drug can significantly shorten the time for AF cardioversion,and reduce heart rate safely and reliably.