目的:比较胺碘酮与普罗帕酮治疗慢性心房颤动复律的临床疗效与安全性。方法:60例慢性心房颤动患者随机均分为普罗帕酮组与胺碘酮组。两组患者均给予治疗原发病、控制症状、阿司匹林、极化液,监测心率、QT间期、P-R间期及QRS时间、血清钾、血清镁水平等常规治疗。在此基础上,普罗帕酮组患者给予盐酸普罗帕酮片450 mg,口服,每日3次,连用3个月,后剂量减为300 mg以维持窦性心律;胺碘酮组患者给予盐酸胺碘酮片200 mg,口服,每日2次,每个月用药7 d,连用3个月,后剂量减为200 mg或100 mg维持窦性心律。观察两组患者的临床疗效,药物复律、电复律、电复律功率、住院时间及不良反应发生情况,并随访48个月的复发率。结果:两组患者的临床疗效、药物复律、电复律、电复律功率、住院时间、不良反应发生率、复发率比较,差异均无统计学意义(P>0.05)。结论:在常规治疗的基础上,胺碘酮与普罗帕酮治疗慢性心房颤动复律的临床疗效和安全性均相当,均可作为治疗慢性心房颤动复律的常规药物。
OBJECTIVE:To compare the clinical efficacy and safety of amiodarone and propafenone in the treatment of chron-ic atrial fibrillation cardioversion. METHODS:60 patients with chronic atrial fibrillation cardioversion were randomly divided into propafenone group and amiodarone group. All patients were given conventional treatment,including treating primary disease,con-trolling symptoms,orally giving aspirin,intravenous infusion of GIK,monitoring heart rate,QT interval,P-R interval,QRS time,serum potassium and serum magnesium,etc. On this basis,propafenone group was orally given propafenone 450 mg for con-tinuous 3 months,3 times a day,and then the dose was decreased to 300 mg to maintain the sinus rhythm;amiodarone group was orally given amiodarone 200 mg for continuous 7 d a month,twice a day,and then the dose was decreased to 200 mg or 100 mg to maintain the sinus rhythm. The clinic data in 2 groups was observed,including clinical efficacy,simple drug cardioversion,elec-trical cardioversion,electrical cardioversion power,hospitalization time and incidence of adverse reactions,and the recurrence rate in 48 months was followed up. RESULTS:There were no significant differences in the clinical efficacy,simple drug cardiover-sion,electrical cardioversion,electrical cardioversion power,hospitalization time,incidence of adverse reactions and recurrence rate between 2 groups(P>0.05). CONCLUSIONS:Based on the conventinal treatment,amiodarone and propafenone have similar clinical efficacy and safety in the treatment of chronic atrial fibrillation cardioversion,and both of them can be used as the conven-tional drugs for treating chronic atrial fibrillation cardioversion.