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|本期目录/Table of Contents|

胺碘酮治疗老年人心律失常的疗效观察

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2010年第1期
页码:
111-113
栏目:
临床研究
出版日期:
2010-01-04

文章信息/Info

Title:
Clinical effect of amiodarone on senile patients suffering from arrhythmia
作者:
孙丽娟1; 王建春2
1.北京朝阳医院京西院区心内科，北京100043;2.山东省立医院保健科，山东 济南 250021
Author(s):
SUN Li-juan1;  WANG Jian-chun2
1.Department of Cardiology, Beijing Chaoyang Hospital (Jingxi Campus), Beijing 100043, China; 2.Department of Health Care, Shandong Provincial Hospital, Jinan 250021, Shandong, China
关键词:
胺碘酮; 心房颤动; 期前收缩; 室性; 频发性
Keywords:
amiodarone;  atrial fibrillation;  premature contraction;  ventricular;  frequency
分类号:
R541.7
DOI:
-
文献标识码:
A
摘要:
目的: 观察胺碘酮对老年人房颤和频发室性早搏的治疗效果，并与普罗帕酮进行疗效比较。方法: 年龄≥60岁的频发室性早搏和房颤患者70例，分入胺碘酮组（Am组，36例）和普罗帕酮组（Pr 组，34例）进行治疗，对频发室性早搏患者随访1个月，对房颤患者随访6~12个月。结果: 两组频发室性早搏，有效率无显著差异；对房颤的转复胺碘酮优于普罗帕酮，但维持窦性心律方面两组有效率无显著差异；两组阵发性心房颤动转复率无显著差异，Pr组转复时间短于Am组（P<0.05）；Am组窦性心律的维持率高于Pr组（P<0.05）。Am组4周时QTc，P-R间期显著延长（P<0.05），左室射血分数（LVEF）无显著变化。Am组不良反应多于Pr组, 因不良反应停药者多于Pr组。结论: 胺碘酮对于老年人频发室性早搏及房颤疗效显著，对心功能影响小，致心律失常作用少见。
Abstract:
AIM: To explore the efficacy of amiodarone on senile patients suffering from frequent premature ventricular contractions and atrial fibrillation. METHODS: We selected 70 patients (aged 60 years) with frequent premature ventricular contractions (PVCs, mean PVCs >30 beats/h) or with atrial fibrillation (AF) and divided them into amiodarone (Am) group and propafenone (Pr) group. These patients were followed-up to observe the effects as well as adverse effects. RESULTS: For frequent PVCs, there was no significant difference between groups. For persistent AF, amiodarone was more effective than propafenone in the conversion of persistent AF (P<0.05), but no significant difference was found between them in the maintenance of sinus rhythm. For paroxysmal AF, there was no significant difference between groups in the conversion rate, but the onset in Pr group was more rapid than in Am group (P<0.05), and the maintenance rate in the Am group was higher than in the Pr group (P<0.05). After 4 weeks, QTc and P-R interval were significantly prolonged in Am group (P<0.05), but no significant change was found in the LVEF value. The number of patients in the Am group suffering from adverse effects was higher than in the Pr group and, as a result, more patients in the Am group withdrew due to adverse effects. CONCLUSION: Amiodrone is effective for frequent PVCs and AF in senile patients with little effect on LVEF value and low proarrhythmic potential.

参考文献/References

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［7］ Herre JM, Sauve MJ, Malone P, et al. Long-term result of amiodarone therapy in patients with recurrent sustained ventricular tachycardia or ventricular fibrillation［J］. J Am Coll Cardiol, 1989, 13(10):442-449.

［8］ Effect of prophylactic amiodarone on mortality after acute myocardial infarction and in congestive heart failure: meta-analysis of individual data from 6500 patients in randomized trials.Amiodarone Trials Meta-analysis Investigators［J］. Lancet, 1997, 350(9089):1417-1423.

［9］ 郭继鸿，刘元生. 心律失常： 机制、 诊断与治疗［M］. 北京: 北京大学医学出版社, 2004:269-270.

备注/Memo

备注/Memo:
收稿日期：2008-6-24.作者简介：孙丽娟，医师，硕士Email:slj767@sina.com
更新日期/Last Update: 2010-01-05