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|本期目录/Table of Contents|

胺碘酮对特发性房颤心房重构逆转作用观察(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2002年第3期
页码:
229-231
栏目:
临床研究
出版日期:
2002-05-01

文章信息/Info

Title:
Effect of Amiodarone on reversion of atrial remodeling in patients with idiopathic atrial fibrillation
作者:
张义飞1;  柳　荫1;  王建榜2;  张录兴1;  郑强荪1
1.第四军医大学唐都医院心内科; 2.陕西省纺织职工医院, 陕西 西安 710038
Author(s):
ZHANG Yi-fei1;  LIU Yin1;  WANG Jian-bang2;  ZHANG Lu-xing1;  ZHENG Qiang-sun1
1.1Departmen t of Cardiology, Tangdu Hospital, Fourth Military Medical University; 2.Shaanxi Spinning and Weaving Hospital, Xi’an Shaanxi, 710038, China
关键词:
胺碘酮;  心房颤动;  重构逆转
Keywords:
amiodarone;  atrial fibrillation;  reversion of atrial remodeling
分类号:
R541.7; R972.2
DOI:
-
文献标识码:
A
摘要:
目的 探讨胺碘酮对特发性房颤的治疗及对逆转心房心肌重构的作用。方法 选择1998206～ 2000207 住院的特发性房颤患者(除外房颤持续时间小于6月和阵发性房颤间隔小于1月, 每次持续时间少于48h 者) 94 例。随机分为胺碘酮治疗组32 例, 普罗帕酮治疗组32 例及安慰剂组30例。治疗前后行心电图、心脏超声、肝、肾功及甲状腺功能检查。出院后嘱患者1, 3, 6, 12 月复查上述项目1 次。结果 胺碘酮与普罗帕酮治疗组, 均可使特发性房颤复律, 但胺碘酮组较普罗帕酮组复律时间稍长(约1周) , 维持窦性心律的作用中, 胺碘酮优于普罗帕酮组, 12月后转复成功率分别为81% 和56% , 与安慰剂组自动复律20% (6/30) 比较有显著差异(P < 0. 01)。随访1, 3, 6, 12 月胺碘酮组左心房直径缩小, 左心室舒张早期经二尖瓣血流的最高值(E 峰值) 和左心房收缩时经二尖瓣血流的最大值(A峰值)、E/A 增大。1, 3, 6, 12 月间比较有显著性差异(P < 0. 01) , 普罗帕酮组上述指标有所改善, 但差异不显著(P >0. 05) , 安慰剂组则无变化。结论 胺碘酮对特发性房颤复律及对逆转心房心肌重构安全有效。
Abstract:
AIM To observe the effect of amiodarone on reversion of atrial remodeling in enlarged atria of patients with idiopathic atrial fibrillation.METHODS 94 continuous inpatients with idiopathic atrial fibrillation who were hospitalized from June 1998 to July 2000 were randomized into amiodarone group (n=32), propafenone group (n=32) and control group(n=30). Electrocardiogram (ECG), ultrasonography of heart, liver function, renal function and thyroid function were measured at before treatment, and 1, 3, 6, 12 month after treatment period respectively.RESULTS Amiodarone and propafenone converted all of atrial fibrillation to sinus rhythm immediately after treatment, with a longer treatment period in amiodarone group (about 1 week) than that of propafenone group. At 12 month after treatment period, there was a significant higher sinus rhythm ratio in amiodarone ( 81%vs20%,P<0.01) and propafenone group (56%vs20%, P<0.01) than control group. There were a smaller left atrial diameter, a higher peak value of blood flow via mitral valve at early left ventricular diastole period (E value), a higher peak value of blood flow via mitral valve at left atrial diastole period (A value) and a higher E/A ratio at 1,3, 6 and 12 month after treatment period than before treatment respectively in amiodarone group,with a significant difference between any two of different time point (P<0.01).CONCLUSION There was a significant effect of amiodarone on reversion of atrial remodeling in enlarged atria of patients with idiopathic atrial fibrillation.

参考文献/References

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[5] Juliaw DG,Camm AJ,Frangin G,et al. For the European myocardial infarction amiodarone trial investigators. Randomised trial of effect of mortality in patients with left-ventricular dysfuction after recent myocardial infarction:EMIAT[J].Lancet,1997,349(9053):667.

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备注/Memo

备注/Memo:
收稿日期：2002-01-14. 第四军医大学武警主治医师提高班学员
更新日期/Last Update: 2005-05-01