胺碘酮与普罗帕酮转复心房颤动临床比较

Clinical comparison between amiodarone and propafenone in cardioversion of atrial fibrillation

目的胺碘酮与普罗帕酮转复心房颤动临床比较。方法我院入选的74例患者按随机数字表法分为胺碘酮组和普罗帕酮组。胺碘酮组（37例）：将胺碘酮150mg加入葡萄糖20mL,15min左右缓慢静脉推注,继之胺碘酮300mg加入葡萄糖500mL,以0.5-1mg/min静滴维持。复律成功后,口服胺碘酮维持。普罗帕酮组（37例）：70mg普罗帕酮静脉注射,于15min左右完成。推注完毕尚未转复者,继之140mg以0.5-1mg/min静滴。复律成功后,口服胺碘酮维持。所有患者均予持续24h心电监护,记录房颤转复的时间,比较两组患者转复率。结果胺碘酮组37例转复成功27例（72.97%）;普罗帕酮组37例转复成功19例（51.35%）;转复成功率胺碘酮组高于普罗帕酮组,差异有显著性（P〈0.05）。两组均未出现明显不良反应。结论胺碘酮治疗心房颤动比普罗帕酮效果好且安全可靠。

Objective To clinically compare amiodarone and propafenone in cardioversion of atrial fibrillation. Methods 74 patients were selected and allocated to amiodarone group and propafenone group based on a random number table. Amidarone group（37 patients）： 150 mg of amidarone was added to 20 mL of glucose, which was intravenously injected in 15 min gradually. Afterwards, 300 mg amidarone was added to 500 mL glucose, which was transfused via intravenous drip at 0.5-1 mg/min. After cardioversion, amidarone was orally administered to maintain the result. Propafenone group（37 patients）： 70 mg of propafenone was injected intravenously in 15 min. For those patients who had not achieved cardioversion after the injection, they would receive intravenous drip of 140 mg of propafenone at 0.5-1.0 mg/min. After cardioversion, amidarone was orally administered to maintain the result. All patients were monitored by 24-hour electrocardiogram. Cardioversion time of atrial fibrillation was recorded and cardioversion rate of the two groups was compared. Results 27 of 37 patients（72.97%） in amidarone group were successful in cardioversion; 19 of 37 patients（51.35%） in propafenone group were successful in cardioversion; the cardioversion rate in amidarone group was higher than that in propafenone group, and the difference was statistically significant（P〈0.05）. Evident adverse effects were not detected in both the two groups. Conclusion Amidarone in the treatment of atrial fibrillation has a better effect than propafenone and is safe and reliable.