美托洛尔控制快速房颤患者心室率的安全性及疗效评价

Safety and Therapeutic Efficacy Evaluation of Intravenous Metoprolol for Control of Ventricular Rate in Patients with Rapid Atrial Fibrillation

【目的】观察美托洛尔控制快速房颤心室率的有效性及安全性。【方法】选择快速房颤患者 (心室率 >1 0 0次 /min) 98例 ,每隔 2min静脉推注美托洛尔 5mg ,连续 3次 ,1 5min后予美托洛尔片剂 5 0mg ,每 6h一次。观察其有效率 (心室率下降≥ 2 0 % )及症状体征变化。【结果】静脉推注美托洛尔 1 5mg后第 1 0min ,有效率 83.7% ,心室率由基础的 (1 33.7± 1 8.3)次 /min下降至 (91 .4± 1 2 .6 )次 /min ;口服美托洛尔 2 4h后有效率达 93.9% ,心室率下降至 (79.5± 8.9)次 /min。 2例患者出现能耐受的低血压状态 (85～ 90 / 5 5～ 6 0mmHg) ,无严重心动过缓 (心率 <5 0次 /min)及Ⅱ、Ⅲ度房室传导阻滞、心功能恶化及死亡等事件。

To observe the safety and efficacy of intravenous metoprolol for control of ventricular rate in patients with rapid atrial fibrillation.Metoprolol 5 mg was injected iv. consecutively for 3 times within 10 min with an interval of 2 min in 98 eligible patients with rapid atrial fibrillation [ventricular rate>100 beats/min(bpm)] , then followed by 50 mg po. q6h. The effective rate (decline of ventricular rate ≥20%) and changes of symptom and physical sign were followed up.The effective rate of 15 mg intravenous metoprolol in 10min after injection was 83.7%, the ventricular rate decreased from (133.7±18.3) bpm to (91.4±12.6) bpm ; while that of metoprolol po. 24 h after administration was 93.9%, and the ventricular rate decreased further to (79.5±8.9) bpm. Tolerable hypotensive state (85～90/55～60 mmHg) appeared in patients, but serious bradycardia (HR <50bpm), atrioventricular block grade Ⅱ/Ⅲ, worsening cardiac function and death were not observed.[Conclusion]Intravenous metoprolol is safe and efficacious to treat the patients with rapid atrial fibrillation.