普罗帕酮和胺碘酮治疗阵发性室上性心动过速的临床疗效

Clinical effect of propafenone and amiodarone on paroxysmal supraventricular tachycardia

目的探讨普罗帕酮与胺碘酮对阵发性室上性心动过速（paroxysmal supraventricular tachycardia,PSVT）患者的临床治疗效果比较。方法回顾性选取2013年6月~2015年6月西安医学院校医院内科的89例PSVT病例为研究样本,按照用药方式的不同,分为普罗帕酮组46例和胺碘酮组43例。比较2组左室收缩末容积、左室舒张末容积、射血分数、复律成功率、平均复律时间、心率的变化及不良反应情况。结果治疗后,2组左室收缩末容积分别为（52.31±8.34）m L/m^2、54.28±7.23）m L/m^2,左室舒张末容积分别为（47.31±8.56）m L/m^2、（45.28±7.16）m L/m^2和射血分数分别为（61.57±0.76）%、（61.39±0.69）%,2组比较差异无统计学意义;治疗后,2组心率均显著下降,普罗帕酮组（85.31±12.84）次/分,胺碘酮组（87.26±11.95）次/分,比较差异无统计学意义,普罗帕酮组复律时间（19.34±4.76）较胺碘酮组快（25.69±6.09）（P〈0.05）,但普罗帕酮组的复律成功率52.17%较胺碘酮组的88.37%低（P〈0.05）;普罗帕酮组的不良反应率21.74%明显高于胺碘酮组的4.65%（P〈0.05）。结论普罗帕酮与胺碘酮复律PSVT均取得较好效果,但普罗帕酮起效较快,平均复律时间较短,适用于急性心动过速,且无严重器质性心脏病患者,胺碘酮起效较慢,但复律成功率较高,用药安全性较高。

Objective To investigate the comparison of the clinical treatment efficacy of propafenone and amiodarone in patients with paroxysmal supraventricular tachycardia（ PSVT）. Methods Retrospective a total of 89 patients with PSVT from June 2013 to June 2015 in our hospital were selected. According to the different administration methods,the patients were divided into the propafenone group of 46 cases and the amiodarone group of 43 cases. The changes of left ventricular end-systolic volume,left ventricular end-diastolic volume,ejection fraction,cardioversion success rate,mean cardioversion time,heart rate and side effects were compared. Results After treatment,the left ventricular end-systolic volume（ 52. 31 ± 8. 34） m L / m^2,（ 54. 28 ± 7. 23） m L/m^2,left ventricular end-diastolic volume（ 47. 31 ± 8. 56） m L/m^2,（ 45. 28 ± 7. 16） m L/m^2 and ejection fraction（ 61. 57 ±0. 76） %,（ 61. 39 ± 0. 69） % were without significant differences. After treatment,the heart rates of the two groups were significantly decreased,the propafenone group（ 85. 31 ± 12. 84） times / min,amiodarone group（ 87. 26 ± 11. 95） times / min,and there were not significant differences. The recovery time of propafenone group was（ 19. 34 ± 4. 76）,higher than the amiodarone group（ 25. 69 ± 6. 09）（ P〈0. 05）. But the success rate of cardioversion（ 52. 17%） was lower than the amiodarone group（ 88. 37%）（ P〈0. 05）. The side effect rates in the propafenone group（ 21. 74%） was significantly higher than that in the amiodarone group（ 4. 65%）（ P〈0. 05）. Conclusion Propafenone and amiodarone cardioversion PSVT have achieved good results,but propafenone rapid onset,the average cardioversion time is short,which is only suitable for acute tachycardia and without serious organic heart disease patients. Amiodarone onset is slower,but the cardioversion success rate is higher.