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目的 研究和比较新型Ⅲ类抗心律失常药物依布利特与普罗帕酮转复心房颤动 (房颤 )的有效性及安全性。方法 采用随机、单盲对照研究。共入选房颤持续 1 5h~89d的患者 69例,其中男性 28例,女性 41例,随机进入依布利特组(n=34)、普罗帕酮组(n=35)。前者于 10min内静脉注射依布利特 1mg,后者于 10min内静脉注射普罗帕酮 70mg,如给药结束 10min后仍未转复为窦性心律,各组重复前述治疗 1次。观察开始给药后 1 5h内房颤的转复率及 4h内的不良反应。结果 (1)依布利特转复房颤的成功率明显高于普罗帕酮(70 .59% vs42 .86%,P<0. 05); (2)房颤的转复率与房颤的持续时间有关,持续时间低于 24h的房颤转复率 ( 71 05%, 27 /38 )明显高于持续时间超过 24h者(38 71%, 12 /31,P<0. 01),其中依布利特对持续 24h之内的房颤转复率高达 83 .33% (15 /18); (3)房颤的转复率与左心房直径呈负相关,左心房直径 <4 0cm患者的转复率 ( 75 68%, 28 /37 )明显高于左心房直径≥4 0cm患者的转复率(34. 38%, 11 /32,P<0 01); (4)依布利特最严重的不良反应为非持续性单形室性心动过速,发生率为 8 .82% (3 /34);普罗帕酮最严重的不良反应为低血压 (2. 86%, 1 /35)及长间歇(RR间期>2 .0s, 11 .43%, 4 /35)。结论 依布利特是一种快速转复
Objective To study and compare the efficacy and safety of ebTI and propafenone, a new type Ⅲ antiarrhythmic drug, in ameliorating atrial fibrillation (atrial fibrillation). Methods Randomized, single-blind controlled study. A total of 69 patients with atrial fibrillation lasting from 15h to 89d, including 28 males and 41 females, were randomized to receive ebutilide (n = 34) and propafenone (n = 35). The former intravenous injection of Ebrian 1mg within 10min, the latter intravenous propafenone 70mg within 10min, such as 10min after the end of the administration has not yet converted to sinus rhythm, the above groups were repeated 1 treatment. The rate of atrial fibrillation and the adverse reactions within 4 hours after the start of administration were observed. Results (1) The success rate of atrial fibrillation after EB was significantly higher than that of propafenone (70.59% vs 42.86%, P <0.05). (2) (71 05%, 27/38) were significantly higher than the duration of more than 24 hours (38 71%, 12/31, P <0.01), of which The conversion rate of atrial fibrillation sustained by ebuterol within 24 hours was 83.33% (15/18). (3) The rate of atrial fibrillation was negatively correlated with the diameter of left atrium. The diameter of left atrium <40 cm (75 68%, 28/37) were significantly higher than that of patients with atrial diameter ≥40 cm (34.38%, 11/32, P <0.01). (4) Embolic The most serious adverse reaction was non-sustained monomorphic ventricular tachycardia, with a rate of 8.82% (3/34). The most serious adverse reactions of propafenone were hypotension (2.86%, 1/35 ) And long interval (RR interval> 2.0s, 11.43%, 4/35). Conclusion Ebutilide is a rapid reversion