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浙江大学学报（医学版）
浙江大学学报（医学版）  2013, Vol. 42 Issue (2): 212-216    DOI: 10.3785/j.issn.1008-9292.2013.02.013
论著     
国产依布利特转复心房颤动/心房扑动的疗效及安全性研究
于忠1，项美香2，马长生3，张树龙4，杨延宗4
1.浙江省杭州市第一人民医院心内科，浙江 杭州 310006;
2.浙江大学医学院附属第二医院心内科，浙江 杭州 310009;
3.首都医科大学附属安贞医院心内科，北京 100029；
4.大连医科大学附属第一医院心内科，辽宁 大连 110006
Efficacy and safety of ibutilide for conversion of atrial fibrillation/flutter
YU Zhong1, XIANG Mei-Xiang2, MA Chang-Sheng3, ZHANG Shu-Long4, YANG Yan-Zong4
1.Department of Cardiology，Hangzhou First Municipal Hospital，Hangzhou 310006,China; 2.Department of Cardiology，The Second Affiliated Hospital，Zhejiang University School of Medicine，Hangzhou 310009,China; 3.Department of Cardiology，Anzhen Hospital of Capital Medical University，Beijing 100029，China; 4.Department of Cardiology，First Hospital of Dalian Medical University，Dalian 110006，China
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摘要：

目的：探讨静脉应用国产依布利特转复心房颤动（房颤）/心房扑动（房扑）的有效性和安全性。
方法：筛选18～75岁，持续时间≤90 d（1 h～90 d），心室率≥60次/min的阵发性或持续性房颤/房扑患者共99例，随机分为依布利特组和普罗帕酮组各49和50例。依布利特组首剂1 mg静注，如无效10 min后再给予1 mg。普罗帕酮组首剂70 mg静注，如无效10 min后再给予70 mg。
结果：两组均能有效降低房颤/房扑的心室率。转复率：依布利特组69.39%（34/49），普罗帕酮组44.00%（22/50），两组差异有统计学意义（P＜0.05）；转复时间：依布利特组显著短于普罗帕酮组（16.79±12.31）min对（36.92±11.38）min，P＜0.01。不良反应：依布利特组最严重的不良反应为非持续性单形性室速，发生率6.12%（3/49），普罗帕酮组多为一过性低血压及长间歇，一例出现急性左心衰。
结论：依布利特转复房颤/房扑的疗效高于普罗帕酮，转复时间短于普罗帕酮，不良反应发生率低，但须在严格监控下进行。
关键词： 抗心律失常药/治疗应用;  普罗帕酮/治疗应用;  心房颤动/药物疗法;  心房扑动/药物疗法;  输注;  静脉内;  治疗效果    
Abstract:

Objective： To investigate the efficacy and safety of intravenous ibutilide for conversion of atrial fibrillation(AF) and flutter(AFL) to sinus rhythm.
Methods： Ninety-nine consecutive patients aged 18-75 y with AF/AFL were included.The duration of arrhythmia was <90 d(1 h-90 d) and ventricular rate was >60 beats/min.Patients were assigned randomly into two groups: 49 patients in ibutilide group received ibutilide 1 mg，then repeated if AF/AFL was not converted after 10 min; 50 patients in propafenone group received propafenone 70 mg，then repeated if AF/AFL persisted after 10 min.Two drugs were diluted by 50 ml of 5% glucose and injected intravenously within 10 min.
Results： Ventricular rates were decreased in both groups.AF/AFL were converted in 34 of 49 patients(69.4%) in ibutilide group and in 22 of 50 patients(44.0%) in propafenone group(P<0.05).The converting time of ibutilide was significantly shorter than that of propafenone\[(16.79±12.31)min vs (36.92±11.38)min,P<0.01\].The most serious adverse effect of ibutilide was non-sustained monomorphic ventricular tachycardia(3/49,6.12%).Transient hypotension and heart pause were the main adverse events in patients who received propafenone，acute left heart failure occurred in one patient of propafenone group.
Conclusions： Intravenous ibutilide is a safe and effective agent for cardioversion of recent-onset AF/AFL.Furthermore，strict processing under electrocardio-monitoring is important.
Key words: Anti-arrhythmia agents/therapeutic use    Propafenone/therapeutic use    Atrial fibrillation/drug therapy    Atrial flutter/drug therapy    Infusions,intravenous    Treatment outcome
收稿日期: 2012-03-12 出版日期: 2013-03-25
:  R 541.75  
作者简介: 于忠（1972-），男，副主任医师，硕士研究生导师，主要从事心血管疾病的介入治疗与研究;E-mail：cyq6395@sina.com
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于忠
项美香
马长生
张树龙
杨延宗

引用本文:

于忠, 项美香, 马长生, 张树龙, 杨延宗. 国产依布利特转复心房颤动/心房扑动的疗效及安全性研究[J]. 浙江大学学报（医学版）, 2013, 42(2): 212-216.

YU Zhong, XIANG Mei-Xiang, MA Chang-Sheng, ZHANG Shu-Long, YANG Yan-Zong. Efficacy and safety of ibutilide for conversion of atrial fibrillation/flutter. Journal of ZheJiang University(Medical Science), 2013, 42(2): 212-216.

链接本文:

http://www.zjujournals.com/med/CN/10.3785/j.issn.1008-9292.2013.02.013    或    http://www.zjujournals.com/med/CN/Y2013/V42/I2/212


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