胺碘酮与盐酸普罗帕酮在院前急救中治疗阵发性室上性心动过速的疗效比较

Comparison of clinical effect between amiodarone and propafenone in prehospital treatment of paroxysmal supraventricular tachycardia

目的研究院前急救中选择胺碘酮与盐酸普罗帕酮治疗阵发性室上性心动过速(paroxysmal supraventricular tachycardia,PSVT)的临床疗效。方法选取2008-01至2016-02福建省某急救指挥中心院前急救PSVT患者78例,随机分成胺碘酮组(n=39)和盐酸普罗帕酮组(n=39),给予相应药物治疗,观察两组患者治疗后PSVT转复有效率、转复时间及药物不良反应。结果经胺碘酮治疗组的转复有效率略优于盐酸普罗帕酮组,但差异无统计学意义;盐酸普罗帕酮组转复所用时间明显短于胺碘酮组[(13.1±3.2)vs(24.8±5.3)h],差异有统计学意义(t=2.07,P=0.003);胺碘酮组不良反应发生率(5.13%)低于盐酸普罗帕酮组(20.51%),差异有统计学意义(P<0.05)。结论院前急救选择胺碘酮与盐酸普罗帕酮转复PSVT均可获得明显疗效,胺碘酮的治疗效果略优于盐酸普罗帕酮,且不良反应较少,但转复时间较长。

Objective To compare clinical efficacy between amiodarone and propafenone in prehospital treatment of paroxysmalsupraventricular tachycardia. Methods 78 cases of an emergency command center in PSVT prehospital emergency patients from 2008,January to 2016, February in Fujian province were selected and randomly divided into amiodarone group （n=39） and propafenone group （n=39）treated by corresponding methods, PSVT cardioversion rate, cardioversion time and adverse drug reaction after treatment ,of the two groupswere observed. Results The effective cardioversion rate of amiodarone group is slightly higher than that of propafenone hydrochloridegroup, but there was no significant difference; cardioversion time of the patients in the hydrochloride group was significantly shorter thanthat in the amiodarone group [（13.1±3.2）vs（24.8±5.3）h ], and the difference was statistically significant （t=2.07, P=0.003）; theincidence of adverse reaction in the amiodarone group （5.13%） was less than that of propafenone group （20.51%）, and the difference wasstatistically significant （P〈0.05）. Conclusions Amiodarone and propafenone both have good effects on the cardioversion of PSVT duringprehospital first aid, the therapeutic effect of amiodarone was slightly higher than that of propafenone, and it has less adverse reactions, butits cardioversion time was slower.