摘要
目的 观察小剂量胺碘酮与普罗帕酮预防房颤发作的临床疗效。方法 73例均为阵发性、持续性或慢性房颤复律后患者 ,排除甲亢所致房颤病例。服用胺碘酮组 4 2例 ,普罗帕酮组 31例。胺碘酮组服用胺碘酮 0 6 g/d ,逐渐减量 ,维持量 0 1g/d至每周 1 0 g/周 ;普罗帕酮组口服普罗帕酮 4 5 0～ 6 0 0mg/d ,维持治疗量为 15 0～ 30 0mg/d。两组病例均长期随访 ,比较两种药物预防房颤发作的疗效 ,并观察药物副作用及服药顺从性。结果 疗效 :胺碘酮组患者在 6个月、12个月及 18个月能够维持窦性心律的患者例数分别为 37、35及 32例 ,分别占该组例数的 88 1%、83 3%及 76 2 %。普罗帕酮组患者在 6个月、12个月及 18个月能够维持窦性心律的患者例数分别为 2 8、2 2及 17例 ,分别占该组例数的 90 3%、77 1%及 5 4 8%。副作用 :两组均见部分病例出现胃肠道反应 ,普罗帕酮组 2例因心衰而停药 ,未发生其他不良反应。结论 作为药物治疗手段 ,胺碘酮及普罗帕酮对于预防房颤复发均有良好的作用 ,但长期疗效胺碘酮优于普罗帕酮 ,并且副作用发生率低、耐受性良好。
Objective 73 patients with atrial fibrillation(Af) in our hospital were treated with low dose of Amidorone and Propatone to prevent Af attack,and their theraputic effects were analysed.Methods The 73 patients with Af were seen in clinic and ward.They all were paroxysmal or sustained or post cardioversion with chronic Af,excluding Af due to hyperthyroxine.There were 42 cases treated with Amidorone,0.6g/d,decreasing dose gradually at the sustained dose of 0.1g pre day to 1.0g per week.31 patients in Propatone group took propatone 450～600mg per day and sustained at the dose of 150～300mg per day.The patients in both groups mentioned above were followed up for a long time to compare the theraputic effect in preventing the attack of Af.At the same time,medication side effect and drug taking compliance were observed,ECG,blood routine,function of liver and kidney were examined before and after taking medications.Results The mumbers patients who sustained sinus rhyth treated with Amidorone were 37,35,32 respectively during follow up periods of 6,12 and 18 months,accounting for 88.1%,83.3% and 76.2% of total patients,which in Propatone treated group were 28,22 and 17,respectively during the same follow up periods as those medtioned abore,accounting for 90.3%,77.1% and 54.8% of total patients.Gastroenteric side effects were observed in parts of patients of both groups.2 patients in Propatone treated group stopped taking the medication due to heart failure.No other side effect were seen.Conclusion Amidorone and Propatone have good poteatial to prevent Af attack,moreorer,from the of point of long term therapy.Amidorone is better than Propatone,and has less side effect and good compliance.
