伊布利特在房性心律失常中的临床应用

Application of ibutilide in clincal atrial arrhythmia

目的观察伊布利特转复心房颤动(atrial fibrillation,AF)和心房扑动(atrial flutter,AFL)的有效性及安全性。方法选取2016年1月~2017年12月在聊城市第二人民医院心内一科住院的持续时间≤3个月的AF、AFL患者32例,随机分为伊布利特组(17例)与胺碘酮组(15例)。伊布利特组首次剂量1mg伊布利特稀释于5%葡萄糖注射液10ml静脉推注,如无效10min后再给予1mg;胺碘酮组首次剂量150mg胺碘酮稀释于5%葡萄糖注射液10ml静脉推注,如无效10min后再给予150mg。结果伊布利特组的AF和AFL转复及总转复率分别为64.3%、66.7%和64.7%,胺碘酮组的AF和AFL转复及总转复率分别为41.7%、33.3%和40.0%,2组比较差异有统计学意义(P<0.05)。伊布利特组平均转复时间为(29.28±12.57)min,胺碘酮组平均转复时间为(70.59±16.83)min,2组比较差异有统计学意义(P<0.01)。治疗前后2组血压、心率比较无统计学差异(P>0.05)。2组不良反应发生率比较无显著差异(17.6%vs 26.7%,P>0.05)。结论伊布利特转复AF、AFL具有起效快,成功率高,安全性好的特点,其疗效优于胺碘酮。

Objective To study the efficacy and safety of ibutilide for AF and atrial flutter.Methods Thirty-two AF and atrial flutter patients with arrhythmia≤3 months were randomly divided into ibutilide treatment group（n=17）and amiodarone treatment group（n=15）.The patients in ibutilide treatment group were treated with 10 ml 5% glucose injection containing 1 mg ibutilide,which was repeated after 10 min if it was ineffective and those in amiodarone treatment group were treated with 10 ml 5% glucose injection containing 150 mg amiodarone,which was repeated after 10 min if it was ineffective.Results The total recovery rate of AF and atrial flutter was significantly higher in ibutilide treatment group than in amiodarone treatment group（64.7% vs40.0%,P〈0.05）.The mean recovery time of AF and atrial flutter was significantly shorter in ibutilide treatment group than in amiodarone treatment group（29.28±12.57 min vs 70.59±16.83 min,P〈0.01）.Conclusion Ibutilide can rapidly recover AF and atrial flutter with a high success rate and a reliable safety.The therapeutic effect of ibutilide is better than that of amiodarone for AF and atrial flutter.