普罗帕酮与胺碘酮治疗阵发性室上性心动过速的临床效果
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摘要
目的对比分析普罗帕酮与胺碘酮治疗阵发性室上性心动过速的临床效果。方法选择在我院就诊的130例阵发性室上性心动过速患者为研究对象,按照患者入院顺序单双号将患者分为对照组和观察组,65例单数患者纳入对照组,采用胺碘酮治疗;65例双数患者纳入观察组,采用普罗帕酮治疗。比较两组患者的疗效、复律情况、治疗前、后心率及不良反应发生情况。结果两组治疗总有效率及复律成功率比较,差异均无统计学意义(P>0.05);观察组复律成功者的平均复律时间显著短于对照组,差异具有统计学意义(P<0.05);治疗前,两组患者的心率比较,差异无统计学意义(P>0.05);治疗后,两组患者的心率均明显降低,差异具有统计学意义(P<0.05),但组间比较,差异无统计学意义(P>0.05);观察组患者的不良反应总发生率高于对照组,差异具有统计学意义(P<0.05)。结论普罗帕酮与胺碘酮在阵发性室上性心动过速患者的治疗中均可发挥积极作用,两者各有利弊,普罗帕酮起效快,但安全性相对较低,而胺碘酮起效慢,但安全性高,适应证广,临床上需根据患者情况合理选择治疗药物。
Objective To compare and analyzed the clinical effects of propafenone and amiodarone in the treatment of paroxysmal supraventricular tachycardia. Methods A total of 130 patients with paroxysmal supraventricular tachycardia treated in our hospital were enrolled as the study objects. Patients were divided into coutrol group and observation group according to single and double number of admission order, 65 cases of patients with single number were enrolled into control group and treated with amiodarone; 65 cases of patients with double number were enrolled into observation group and treated with propafenone. The treatment effects, cardioversion, heart rates before and after treatment and adverse reactions in both groups were compared. Results There were no significant differences in the total effective rate of treatment and the success rate of cardioversion between the two groups(P >0.05). The average cardioversion time of successful cardioversion patients in the observation group was significantly shorter than that in the control group(P <0.05). Before treatment, there was no significant difference in heart rates between the two groups(P>0.05). After treatment, the heart rates of both groups decreased, the differences were statistically significant(P <0.05), but there was no significant difference between the groups(P>0.05). The total incidence of adverse reactions in the observation group was significantly higher than that in the control group, the difference was statistically significant(P<0.05). Conclusion Propafenone and amiodarone can play active role in the treatment of patients with paroxysmal supraventricular tachycardia. Both of two methods have advantages and disadvantages. Propafenone has a fast onset, but with relatively low safety. Amiodarone has a slow onset, but with high safety and wide indications. It is necessary to choose a therapeutic drug according to the patients' condition.
Objective To compare and analyzed the clinical effects of propafenone and amiodarone in the treatment of paroxysmal supraventricular tachycardia. Methods A total of 130 patients with paroxysmal supraventricular tachycardia treated in our hospital were enrolled as the study objects. Patients were divided into coutrol group and observation group according to single and double number of admission order, 65 cases of patients with single number were enrolled into control group and treated with amiodarone; 65 cases of patients with double number were enrolled into observation group and treated with propafenone. The treatment effects, cardioversion, heart rates before and after treatment and adverse reactions in both groups were compared. Results There were no significant differences in the total effective rate of treatment and the success rate of cardioversion between the two groups(P >0.05). The average cardioversion time of successful cardioversion patients in the observation group was significantly shorter than that in the control group(P <0.05). Before treatment, there was no significant difference in heart rates between the two groups(P>0.05). After treatment, the heart rates of both groups decreased, the differences were statistically significant(P <0.05), but there was no significant difference between the groups(P>0.05). The total incidence of adverse reactions in the observation group was significantly higher than that in the control group, the difference was statistically significant(P<0.05). Conclusion Propafenone and amiodarone can play active role in the treatment of patients with paroxysmal supraventricular tachycardia. Both of two methods have advantages and disadvantages. Propafenone has a fast onset, but with relatively low safety. Amiodarone has a slow onset, but with high safety and wide indications. It is necessary to choose a therapeutic drug according to the patients' condition.
引文
[1]王少波,梁锦军,黄从新.静脉注射胺碘酮与普罗帕酮治疗阵发性室上性心动过速疗效的Meta分析[J].疑难病杂志,2013,12(1):2-4.
[2]冯艳,李国梁.普罗帕酮和胺碘酮急诊转复阵发性室上性心动过速的疗效比较[J].现代中西医结合杂志,2014,23(13):1405-1407.
[3]SATO Y,NAGATA H,INODA A,et al.Cardioversion for paroxysmal supraventricular tachycardia during lung surgery in a patient with concealed Wolff-Parkinson-White syndrome[J].Masui,2014,63(10):1106-1110.
[4]牟博勇,蔺曜,曾朝富.普罗帕酮和胺碘酮及维拉帕米治疗阵发性室上性心动过速疗效的对比研究[J].实用心脑肺血管病杂志,2013,21(12):82-83.
[5]宋清泉,周晓宏,程缙,等.普罗帕酮和胺碘酮急诊转复阵发性室上性心动过速的疗效比较[J].实用心脑肺血管病杂志,2013,21(1):46-47.
[6]苏文坚,梁启辉,李昌汶.胺碘酮与普罗帕酮联合直流电复律治疗室上性心动过速疗效比较[J].海南医学,2017,27(8):1330-1331.
[7]罗晓玲,李东锋,刘仁斌.中药复方罗布麻片联合胺碘酮治疗冠心病室性心律失常的临床效果分析[J].医学综述,2015,21(17):3218-3220.
[8]常锡峰,徐文莉,陈茜薇,等.胺碘酮与普罗帕酮治疗老年阵发性心房颤动疗效与安全性研究[J].老年医学与保健,2014,20(4):269-271.
[9]杨智勇.普罗帕酮联合稳心颗粒治疗阵发性室上性心动过速140例的疗效观察[J].环球中医药,2013,6(s2):159-160.
[10]王晓君,张守焰,徐志平.小剂量普罗帕酮联合磷酸肌酸钠治疗妊娠期高血压合并阵发性室上性心动过速100例分析[J].广西医学,2017,39(3):406-407.
[11]李晓萍,蒲友敏.三磷酸腺苷、维拉帕米及胺碘酮在治疗阵发性室上性心动过速中的疗效观察[J].第三军医大学学报,2013,35(19):2119-2120.
[12]ZOFIA K,KATARZYNA S,WALDEMAR B,et al.Amiodarone-induced thyrotoxicosis with paroxysmal supraventricular(ectopic atrial)tachycardia:case report and review of the literature[J].Arch Med Sci,2013,9(2):372-376.
[13]马仙红,邢巧莉.稳心颗粒联合普罗帕酮治疗室性心动过速的临床疗效观察[J].药物评价研究,2016,39(6):1058-1060.
[14]陈悦,宋涛,初巍巍,等.静脉注射胺碘酮治疗急性心肌梗死伴室性心动过速和心室纤颤的临床效果观察[J].医学综述,2013,19(9):1684-1685.
[15]陶国高.普罗帕酮合用环磷腺苷治疗室上性心动过速120例[C].//第8届中国南方国际心血管病学术会议,2006.
[16]BANHIDY F,ACS N,PUHOEH,et al.Paroxysmal supraventricular tachycardia in pregnant women and birth outcomes of their children:a population-based study[J].Am J Med Genet A,2015,167(8):1779-1786.
[17]QIAN LY,ZOU H,CHE XD,et al.Comparison of radiofrequency catheter ablation for paroxysmal supraventricular tachycardia guided by three dimensional navigation with X-ray[J].Zhonghua Yi Xue Za Zhi,2016,96(35):2821-2824.
[2]冯艳,李国梁.普罗帕酮和胺碘酮急诊转复阵发性室上性心动过速的疗效比较[J].现代中西医结合杂志,2014,23(13):1405-1407.
[3]SATO Y,NAGATA H,INODA A,et al.Cardioversion for paroxysmal supraventricular tachycardia during lung surgery in a patient with concealed Wolff-Parkinson-White syndrome[J].Masui,2014,63(10):1106-1110.
[4]牟博勇,蔺曜,曾朝富.普罗帕酮和胺碘酮及维拉帕米治疗阵发性室上性心动过速疗效的对比研究[J].实用心脑肺血管病杂志,2013,21(12):82-83.
[5]宋清泉,周晓宏,程缙,等.普罗帕酮和胺碘酮急诊转复阵发性室上性心动过速的疗效比较[J].实用心脑肺血管病杂志,2013,21(1):46-47.
[6]苏文坚,梁启辉,李昌汶.胺碘酮与普罗帕酮联合直流电复律治疗室上性心动过速疗效比较[J].海南医学,2017,27(8):1330-1331.
[7]罗晓玲,李东锋,刘仁斌.中药复方罗布麻片联合胺碘酮治疗冠心病室性心律失常的临床效果分析[J].医学综述,2015,21(17):3218-3220.
[8]常锡峰,徐文莉,陈茜薇,等.胺碘酮与普罗帕酮治疗老年阵发性心房颤动疗效与安全性研究[J].老年医学与保健,2014,20(4):269-271.
[9]杨智勇.普罗帕酮联合稳心颗粒治疗阵发性室上性心动过速140例的疗效观察[J].环球中医药,2013,6(s2):159-160.
[10]王晓君,张守焰,徐志平.小剂量普罗帕酮联合磷酸肌酸钠治疗妊娠期高血压合并阵发性室上性心动过速100例分析[J].广西医学,2017,39(3):406-407.
[11]李晓萍,蒲友敏.三磷酸腺苷、维拉帕米及胺碘酮在治疗阵发性室上性心动过速中的疗效观察[J].第三军医大学学报,2013,35(19):2119-2120.
[12]ZOFIA K,KATARZYNA S,WALDEMAR B,et al.Amiodarone-induced thyrotoxicosis with paroxysmal supraventricular(ectopic atrial)tachycardia:case report and review of the literature[J].Arch Med Sci,2013,9(2):372-376.
[13]马仙红,邢巧莉.稳心颗粒联合普罗帕酮治疗室性心动过速的临床疗效观察[J].药物评价研究,2016,39(6):1058-1060.
[14]陈悦,宋涛,初巍巍,等.静脉注射胺碘酮治疗急性心肌梗死伴室性心动过速和心室纤颤的临床效果观察[J].医学综述,2013,19(9):1684-1685.
[15]陶国高.普罗帕酮合用环磷腺苷治疗室上性心动过速120例[C].//第8届中国南方国际心血管病学术会议,2006.
[16]BANHIDY F,ACS N,PUHOEH,et al.Paroxysmal supraventricular tachycardia in pregnant women and birth outcomes of their children:a population-based study[J].Am J Med Genet A,2015,167(8):1779-1786.
[17]QIAN LY,ZOU H,CHE XD,et al.Comparison of radiofrequency catheter ablation for paroxysmal supraventricular tachycardia guided by three dimensional navigation with X-ray[J].Zhonghua Yi Xue Za Zhi,2016,96(35):2821-2824.
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