尼非卡兰与胺碘酮治疗严重室性心律失常近期疗效及安全性的对比研究

Comparative study of Nifekalant versus Amiodarone for severe ventricular arrhythmia

目的:本研究旨在对比尼非卡兰和胺碘酮在治疗严重室性心律失常患者中的疗效和安全性。方法:本研究为单中心回顾性观察研究。收集2015-10-2018-02于泰达国际心血管病医院心内重症监护病房住院治疗,并出现持续性室性心动过速(室速)/心室颤动(室颤)患者共84例。据药物治疗方案分为胺碘酮组(42例)和尼非卡兰组(42例)。对有效率、转复时间、24h生存率、1个月生存率、转复前后的收缩压、舒张压、心率及左心室射血分数、不良反应和无效患者死亡的原因等指标应用SPSS 22.0软件进行统计学分析。结果:尼非卡兰较胺碘酮可有效转复持续性室速/室颤(P<0.05),并可缩短转复时间(P<0.01),并提高24h生存率、1个月生存率(P<0.05)。两者的不良反应发生率、转复无效患者的死亡原因无明显统计学差异(P=0.51)。另外,尼非卡兰对舒张压(P=0.13)、收缩压(P=0.09)、心率(P=0.15)无明显影响,可有效升高左心室射血分数(P<0.01)。结论:静脉应用尼非卡兰治疗持续性室速/室颤时,疗效优于胺碘酮,且安全性高。

Objective:To compare the effectiveness and tolerance of nifekalant and amiodarone in patients with severe ventricular arrythmia.Method:We included 84 patients with persistent ventricular tachycardia or ventricular fibrillation admitted into cardiac intensive care unit(CCU)of TEDA International Cardiovascular Hospital from October 2015 to February 2018.According anti-arrythma drugs which used by patient,we divided patients into nifekalant group and amiodarone group.We analysed the efficiency,systolic blood pressure,left ventricular eject fraction,24-hour survival rate,30-day survival rate,adverse reactions,causes of invalid patients’ death by SPSS 22.0software.Result:Nifekalant was more effective than amiodarone in the recovery of persistent ventricular tachycardia/ventricular fibrillation,and the difference was statistically significant(P<0.01).Compared with amiodarone,nifekalant could shorten the recovery time and improve the 24-hour survival rate and 30-day survival rate,and the difference was statistically significant(P<0.01).There was no significant difference in the incidence of adverse reaction and the causes of death between nifekalant and amiodarone(P>0.05).The effect of nifekalant on blood pressure and cardiac function was small,and the difference was statistically significant(P<0.05).Otherwise,nifekalant was effective in increasing left ventricular ejection fraction(P<0.01),and had no significant effect on diastolic pressure(P=0.13),systolic blood pressure(P=0.09)and heart rates(P=0.15).Conclusion:The application of nifekalant to treat persistent ventricular tachycardia/ventricular fibrillation is superior to amiodarone in this study.