三磷酸腺苷、普罗帕酮和西地兰治疗阵发性室上速的效果对比

Effects comparison of adenosine triphosphate, propafenone and cedilanid in treatment of paroxysmal supraventricular tachycardia

目的对比三磷酸腺苷、普罗帕酮和西地兰治疗阵发性室上速的效果。方法选取2013年12月～2015年12月期间本院收治的93例阵发性室上速患者，根据随机数字表法分为A、B、C组，31例每组。A组采取三磷腺苷进行治疗，B组采取普罗帕酮进行治疗，c组采取西地兰进行治疗。比较三组患者治疗前和治疗后心律、超敏C反应蛋白（hs-CRP）、血浆N端脑钠素前体（NT-ProBNP）、心钠素（ANP）水平变化情况，分析三组患者的临床疗效和不良反应。结果A组总的有效率显著高于B组、C组[90．32％（28／31）比80．65％（25／31761．29％（19／31）]（P〈0．05）。治疗后，A组的平均心室率显著低于B组、C组[（71．43±6．32）次／rain比（77．13±7．43）次／min、（94．35±8．13）次／minl，差异均有统计学意义（P〈0．05）。A组的hs-CRP、NT-ProBNP、ANP水平显著低于B组、c组f（1．32±0．13）mg／L、（165．43±4．32）μg／L、（104．32±5．43）μg／L比（1．48±0．17）mg／L、（212．13±6．43）μg／L、（112．43±7．54）μg／L，（1．84±0．21）mg／L、（275．43±7．98）μg／L、（121．46±8．03）μg／L]P〈0．05）。A组总的不良反应率显著高于B组、c组[80．65％（25／31）比9．68％（3／31）、3．23％（1／31）]，差异具有统计学意义（P〈0．05）。结论在治疗阵发性室上速的药物复律中，采取三磷酸腺苷方案可有效降低患者的hs-CRP、NT-ProBNP、ANP水平及平均心室率，临床疗效良好，但不良反应率较高，因此，应按照临床类型的不同，选取不同的治疗药物，了解好患者的禁忌证和适应证，进而增加药物复律的成功率。

Objective To compare effects of adenosine triphosphate, propafenone and cedilanid on paroxysmal supraventricular tachycardia. Methods 93 patients with paroxysmal supraventricular tachycardia admitted in our hospital from December 2013 to December 2015 were selected as research objects. According to random number method, those patients were divided into group A, group B, group C,31 cases of each group. Patieants in group A were treated with adenosine triphosphate, patients in group B was treated with propafenone, and patients in group C were treated with cedilanid. The heart rate, levels of high-sensitivity C-reactive protein （hs-CRP）, plasma N-terminal pro-brain natriuretic peptide （NT-ProBNP） and atrial natriuretic peptide （ANP） chanes before and after the treatment were compared. The clinical curative effect and adverse reaction were analyzed. Results The total effective rate in group A was significantly higher than that in group B and C [90.32% （28/31） vs 80.65% （25/31）/61.29% （19/31）] （P 〈 0.05）. After treatment, the mean ventricular rate in group A was significantly lower than that in group B, group C [（71.43 ± 6.32） time/min VS（77.13 ± 7.43） time/min, （94.35 ± 8.13）time/min ], and the difference was statistically significant （P 〈 0.05）. The levels dhs-CRP, NT-ProBNP and ANP in group A were significantly lower than those in group B and C [（1.32 ± 0.13）mg/L, （165.43 ± 4.32） μg/L, （104.32 ± 5.43）μg/L VS （1.48 ± 0.17）mg/L, （212.13 ± 6.43） μg/L, （112.43 ± 7.54） μg/L, （1.84 ± 0.21）mg/L, （275.43± 7.98） μg/L, （121.46 ± 8.03） μ g/L] （P 〈 0.05）. The total adverse reaction rate in group A was significantly higher than that in group B [（80.65%（25/31） vs 9.68%（3/31）, 3.23%（1/31）, P 〈 0.05）, and the difference was statistically significant （P 〈 0.05）. Conclusion In the treatment of paroxysmal supraventricular tachycardia drug cardioversion, adenosine triphosphate can reduce the level of CRP, NT-ProBNP, ANP and the average ventricular rate, the clinical efficacy is good, but the rate of adverse reactions is high. Therefore, it is important to select different treatment drugs, according to different clinical types. It is important to understand the good contraindications and indications of patients should be in, thereby increasing the success rate of drug cardioversion.