伊布利特在控制转复阵发性房颤中的作用研究

Research of ibutilide on cardioversion of paroxysmal atrial fibrillation

目的比较伊布利特与胺碘酮和普罗帕酮在转复阵发房颤中的疗效及安全性。方法选择阵发性房颤患者90例,随机分成依布利特组(A组)、胺碘酮组(B组)、普罗帕酮组(C组),每组30例。于入院10min内,三组分别经静脉注射依布利特1 mg、胺碘酮150 mg、普罗帕酮70 mg。观察10 min后若仍未转复为窦性心律,重复首次剂量。观察开始给药后1、2、4、24 h内房颤的转复率、转复时间、心室率、QT和QRS间期变化及用药后不良反应的发生情况。结果 A组在各时间点房颤的转复率(83.33%)均显著高于其他组。A组转复时间(24.3±10.7)min明显短于其他组。A组不反应发生率(3.33%)明显低于C组,但与B组比较差异无统计学意义。各组用药后心率均显著降低,A组给药后QT间期较B组和C组显著延长,B组QT间期在用药各时段无明显变化。C组给药后的QRS间期较A组和B组明显延长,A组和B组的QRS间期用药后无明显变化。结论伊布利特对房颤转复的效果优于胺碘酮和普罗帕酮,伊布利特对心室率和QT间期的影响大于胺碘酮和普罗帕酮,但对QRS间期无明显影响。伊布利特是一种转复房颤快速、有效的药物。

Objective To assess the therapeutic efficacy and safety on paroxysmal atrial fibrillation with ibutilide versus amiodaron and propafenone.Methods 90 patients with paroxysmal atrial fibrillation were randomly divided into three groups.Group A was treated with ibutilide（1 mg,iv,n=30）,group B was given amiodarone（150 mg,iv,n=30） and Group C was given propafenone（70 mg,iv,n=30）.The study drugs were infused within 10 minutes in aids of ECG and blood pressure monitoring.The patient who remained AF after treatment repeated the prior infusion.The cardioversion rate and time,heart rate,QT interval,QRS interval and adverse effects within 1 h,2 h,4 h,24 h were recorded.Results The cardioversion rate and cardioversion time of group A was 83.33% and（24.3±10.7）min,respectively superior to those of the other groups.The adverse effects of group A was 3.33%,lower than that of the group C,while compared with group B,there was no significant statistic difference.The heart rates all decreased after treatment.The QT interval of group A was significantly prolonged compared with the other groups.There was no obvious change in group B.The QRS interval of group C was significantly prolonged compared with the other groups.The QRS intervals of group B and group C had no changes.Conclusion The efficacy of ibutilide in treating paroxysmal atrial fibrillation is superior to amiodarone and propafenone.The effect of ibutilide on heart rate and QT interval is more significant than amiodarone and propafenone,while it has no effect on QRS interval.Ibutilides is an effective and safe drug in atrial fibrillation cardioversion