天津医药

• 短篇论著 •    下一篇

急诊老年心房颤动快速心室率患者临床用药效果观察

赵志强1,李广平2,刘相丽1,富华颖2,张晓伟3   

  1. 1. 天津医科大学第二医院
    2. 天津医科大学第二医院心脏科
    3. 天津医大二院心脏科
  • 收稿日期:2011-11-02 修回日期:2012-07-19 出版日期:2012-11-15 发布日期:2012-11-15
  • 通讯作者: 赵志强

A comparative study on the efficacy and safety of intravenous lanatoside C, dilti- azem and amiodarone in patients with atrial fibrillation of rapid ventricular rate

  • Received:2011-11-02 Revised:2012-07-19 Published:2012-11-15 Online:2012-11-15

PDF (PC)

2276

摘要： 摘要 目的：观察并比较静脉注射毛花甙C、地尔硫卓及胺碘酮控制老年房颤伴快速心室率的有效性和安全性。方法：收集于天津医科大学第二医院心脏科急诊诊治的心房颤动伴快速心室率的老年患者(≥60岁)97例，患者随机分为3组，分别静脉用毛花甙C(A组，30例)组、地尔硫卓(B组，32例)和胺碘酮(C组，35例)组。观察用药前及用药后5、l0、15、30、60、90min患者的心室率、血压、心律变化以及药物起效时间及不良反应。结果：毛花甙C、地尔硫卓和胺碘酮均能有效控制心房纤颤伴快速心室率患者的心室率。总有效率分别为75％、90％和85％，平均用药有效时间分别为(35.4±15.7)min、(9.7±3.6) min和(18.8±7.6)min。西地兰组恢复窦律6例，低血压l例；地尔硫卓组恢复窦律5例,出现低血压2例，窦缓l例；胺碘酮组恢复窦律8例，窦缓l例；均自行缓解，未发生心衰加重。结论：毛花甙C、地尔硫卓及胺碘酮均能有效、迅速、安全控制老年房颤伴快速心室率患者的心室率。但地尔硫卓、胺碘酮更迅速，而胺碘酮相对安全。

关键词: 心房颤动, 老年, 心室率, 毛花甙C, 地尔硫卓, 胺碘酮

Abstract: Abstract 0bjective: To evaluate the efficacy and safety of intravenous lanatoside C, diltiazem and amiodarone for controlling rapid ventricular rate in patients with atrial fibrillation(AF) in gerontal patient．Methods: 97 AF elderly patients(over 60 year old) with rapid atrial ventricular rate(≥120 beats/min) were randomly divided into 3 groups, the lanatoside C group(30 cases), group diltiazem(32 subjects) and group amiodarone (35 patients)．The heart rate, blood pressure, rhythm were recorded before treatment, at 5, 10, 15, 30, 60 and 90 min after treatment．The reacting time，side effects including hypotension, bradyeardia, nausea, vomiting, dizziness, etc, were analyzed. Results: lanatoside C, diltiazem and amiodarone are equally safe and effective on controlling rapid ventricular rate in elderly patients with atrial fibrillation and total effective rate were 75％，90％ and 85％. With the mean time response to the bolus was(35.4±15.7)min,(9.7±3.6)min and(18.8±7.6)min, respectively．In lanatoside C group , sinus rhythm was restored in 6 patients and asymptomatic hypotension developed in 1 patient. In diltiazem group, sinus rhythm was restored in 5 patients, asymptomatic hypotension developed in 2 patients and sinus bradycardia developed in 1 patient. In amiodarone group, sinus rhythm was restored in 8 patients and sinus bradycardia developed in 1 patient. All events were resolve without pharmacologic treatment. No patient developed worsening of congestive heart fililure due to lanatoside C, diltiazem and amiodarone. Conclusion: compared with lanatoside C, diltiazem and amiodarone are safe and effective in acutely 1owing of rapid ventricular rate in patients with atrial fibrillation. but diltiazem is more rapid and amiodarone is relatively safe in controlling AF with rapid ventricular response．

Key words: atrial fibrillation, gerontal, heart rate, Lanatoside C, Diltiazem, amiodarone