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目的 :观察索他洛尔 (So)治疗难治性慢性室性早搏 (VPC)和症状性阵发性心房颤动 (PAF)的疗效、作用特点和不良反应。方法 :2 8例慢性 VPC患者和 16例 PAF患者接受 So治疗 ,起始剂量 12 0～ 16 0 m g/ d,无效则递增 ,最大剂量 32 0 mg/ d。根据 2 4h Holter监测的早搏数量减少评价 VPC疗效 ,以立方根法计算 QTc间期。结果 :So治疗 VPC的总有效率为 78.6 % ,短期 (8wk)内预防 PAF发作的有效率为 31.3% ,伴有 SBP降低、HR减慢和 QT间期、QTc间期延长、QT间期离散度 (QTd)明显缩短 (P<0 .0 1) ,但缩短程度在治疗有效和无效者差异不显著 (P>0 .0 5 )。全组未见心律失常恶化 ,但 13.6 % (6 / 44 )的患者出现持续性窦性心动过缓 ,仅有的 1例慢性充血性心力衰竭患者于服药 wk 2出现心衰恶化。其余不良反应较少。结论 :So治疗难治性 VPC的作用较好 ,可作为一线抗心律失常药物使用 ,但预防 PAF发作的疗效较差。
OBJECTIVE: To observe the curative effect, action characteristics and adverse reactions of soxalol (So) on refractory chronic premature ventricular contractions (VPC) and symptomatic paroxysmal atrial fibrillation (PAF). Methods: Twenty-eight patients with chronic VPC and 16 patients with PAF received So treatment at a starting dose of 120 to 160 mg / d, with an increasing dose of up to 32 mg / d. The curative effect of VPC was evaluated based on the reduction of the number of premature beats monitored by 24 h Holter, and the QTc interval was calculated by the cubic root method. Results: The total effective rate of Sov’s treatment of VPC was 78.6%. The effective rate of prevention of PAF within short-term (8wk) was 31.3%, accompanied by decreased SBP, slowed HR, QT interval, QTc interval prolongation, QT interval discretization (QTd) was significantly shorter (P <0. 01), but the shortening was not significantly different between the effective and ineffective (P> 0.05). No worsening of arrhythmia was seen in the whole group, but persistent sinus bradycardia occurred in 13.6% (6/44) of the patients and only 1 of the patients with chronic congestive heart failure developed worsening of heart failure on wk 2 administration. The remaining adverse reactions less. CONCLUSIONS: So is a good treatment for refractory VPC and can be used as a first-line anti-arrhythmic drug, but its efficacy in preventing PAF is poor.