普罗帕酮与胺碘酮治疗阵发性室上性心动过速的疗效与安全性
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摘要
目的:研究比较普罗帕酮与胺碘酮治疗阵发性室上性心动过速(PSVT)的疗效与安全性。方法:选择本院2013年1月～2018年5月收治的90例PSVT患者纳入本次研究。患者被随机均分为普罗帕酮组和胺碘酮组,两组均在常规治疗基础上接受相应药物治疗24h。观察比较两组患者治疗前后的血压水平、心率、心功能指标:LVEDV、LVESV和LVEF,对比两组的转复时间、60min内转复成功率以及治疗期间两组不良反应发生情况。结果:两组PSVT转复率(普罗帕酮组91.11%比胺碘酮组93.33%)无显著差异(P=1.000)。与治疗前比较,治疗24h后两组血压水平、心率均显著降低,P均=0.001;但治疗前后两组间均无显著差异,P均>0.05。普罗帕酮组转复时间[(12.66±2.06)min比(22.80±2.28)min]显著短于胺碘酮组,P=0.001。与普罗帕酮组比较,胺碘酮组治疗24h后LVEF显著升高[(63.24±3.67)%比(66.83±4.01)%],LVEDV显著降低[(96.65±5.24)ml比(92.09±4.37)ml],LVESV显著降低[(38.40±2.87)ml比(30.13±7.34)ml],P均=0.001。胺碘酮组不良反应总发生率(8.89%比24.44%)显著低于普罗帕酮组,P=0.048。结论:普罗帕酮与胺碘酮治疗阵发性室上性心动过速均具有显著疗效,普罗帕酮转复时间短,胺碘酮不良反应少且可提高心功能水平,临床上应根据患者的具体情况选择应用药物。
Objective: To compare therapeutic effect of propafenone and amiodarone on paroxysmal supraventricular tachycardia(PSVT) and their safety. Methods:A total of 90 PSVT patients, who were treated in our hospital from Jan 2013 to May 2018, were selected. Patients were randomly and equally divided into propafenone group and amiodarone group, each group received corresponding medication based on routine treatment for 24 h. Blood pressure, heart rate, cardiac function indexes: LVEDV, LVESV and LVEF before and after treatment, cardioversion time, successful cardioversion rate within 60 min and incidence of adverse reactions during treatment were observed and compared between two groups. Results:There was no significant difference in successful cardioversion rate(propafenone group 91.11% vs. amiodarone group 93.33%, P=1.000)between two groups. Compared with before treatment, on 24 h after treatment, there were significant reductions in blood pressure and heart rate in two groups, P=0.001 all; but there was no significant difference between two groups before and after treatment, P>0.05 all. Cardioversion time of propafenone group was significantly shorter than that of amiodarone group [(12.66±2.06)min vs.(22.80±2.28)min], P=0.001.Compared with propafenone group on 24 h after treatment,there was significant rise in LVEF[(63.24±3.67)% vs.(66.83±4.01)%], significant reductions in LVEDV[(96.65±5.24)ml vs.(92.09±4.37)ml]and LVESV[(38.40±2.87)ml vs.(30.13±7.34)ml]in amiodarone group,P=0.001 all. Total incidence rate of adverse reactions in amiodarone group was significantly lower than that of propafenone group(8.89% vs. 24.44%), P=0.048. Conclusion:Propafenone and amiodarone possess significant therapeutic effect on PSVT. Propafenone possesses shorter cardioversion time, while amiodarone possesses less adverse reactions and improve cardiac function. Therefore, medication should be selected properly according to patient′s specific condition in clinic.
Objective: To compare therapeutic effect of propafenone and amiodarone on paroxysmal supraventricular tachycardia(PSVT) and their safety. Methods:A total of 90 PSVT patients, who were treated in our hospital from Jan 2013 to May 2018, were selected. Patients were randomly and equally divided into propafenone group and amiodarone group, each group received corresponding medication based on routine treatment for 24 h. Blood pressure, heart rate, cardiac function indexes: LVEDV, LVESV and LVEF before and after treatment, cardioversion time, successful cardioversion rate within 60 min and incidence of adverse reactions during treatment were observed and compared between two groups. Results:There was no significant difference in successful cardioversion rate(propafenone group 91.11% vs. amiodarone group 93.33%, P=1.000)between two groups. Compared with before treatment, on 24 h after treatment, there were significant reductions in blood pressure and heart rate in two groups, P=0.001 all; but there was no significant difference between two groups before and after treatment, P>0.05 all. Cardioversion time of propafenone group was significantly shorter than that of amiodarone group [(12.66±2.06)min vs.(22.80±2.28)min], P=0.001.Compared with propafenone group on 24 h after treatment,there was significant rise in LVEF[(63.24±3.67)% vs.(66.83±4.01)%], significant reductions in LVEDV[(96.65±5.24)ml vs.(92.09±4.37)ml]and LVESV[(38.40±2.87)ml vs.(30.13±7.34)ml]in amiodarone group,P=0.001 all. Total incidence rate of adverse reactions in amiodarone group was significantly lower than that of propafenone group(8.89% vs. 24.44%), P=0.048. Conclusion:Propafenone and amiodarone possess significant therapeutic effect on PSVT. Propafenone possesses shorter cardioversion time, while amiodarone possesses less adverse reactions and improve cardiac function. Therefore, medication should be selected properly according to patient′s specific condition in clinic.
引文
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[9]郝春颖,黄园园.胺碘酮、普罗帕酮对老年心律失常患者心率变异及高敏C反应蛋白的影响[J].中国老年学杂志,2018,38(6):1328-1330.
[10]Khachab H,Brembilla-Perrot B.Prevalence of atrial fibrillation in patients with history of paroxysmal supraventricular tachycardia[J].Int J Cardiol,2013,166(1):221-224.
[11]程征,周子华,陈玺军.普罗帕酮与胺碘酮转复心房颤动效果的Meta分析[J].临床心血管病杂志,2016,32(7):702-706.
[12]曾文军,高彦文,李海涛.普罗帕酮与胺碘酮治疗心律失常效果对比及其对血清hs-CRP的影响[J].山东医药,2015,55(28):42-44.
[13]Kamel H,Elkind MS,Bhave PD,et al.Paroxysmal supraventricular tachycardia and the risk of ischemic stroke[J].Stroke,2013,44 (6):1550-1554.
[14]徐加红.静脉注射普罗帕酮治疗阵发性室上性心动过速的疗效[J].心血管康复医学杂志,2015,24(5):561-564.
[15]王会洪,黄鹤,任贻强.参松养心胶囊联合低剂量胺碘酮治疗室性心律失常的疗效分析[J].中国药房,2017,28(21):2926-2929.
[2]Savelieva I,Graydon R,Camm AJ.Pharmacological cardioversion of atrial fibrillation with vernakalant:evidence in sup-port of the ESC Guidelines [J].Europace,2014,16 (2):162-173.
[3]王鹏,姚光涛,王莉,等.索他洛尔联合稳心颗粒对心动过速患者心率及血浆AngⅡ与VIP含量影响的研究[J].中华中医药学刊,2016,34(3):763-766.
[4]傅彪,黎扬,陈国柱.定心汤配合胺碘酮治疗阵发性室上性心动过速的疗效观察[J].中药药理与临床,2017,33(5):175-177.
[5]周聪,黄南清,林锡民.胺碘酮与三磷酸腺苷治疗阵发性室上性心动过速的效果比较[J].广东医学,2015,36(14):2243-2244.
[6]吉立双,孙丽颖,刘刚,等.不同曝光方式下行导管射频消融治疗阵发性室上性心动过速的疗效及安全性比较[J].重庆医学,2017,46(22):3057-3059.
[7]陈灏珠.实用内科学[M].北京:人民卫生出版社.第12 版,2005:319-320.
[8]张娜.阿替洛尔治疗老年快速心律失常的临床效果研究[J].中国全科医学,2016,19(12):165-166.
[9]郝春颖,黄园园.胺碘酮、普罗帕酮对老年心律失常患者心率变异及高敏C反应蛋白的影响[J].中国老年学杂志,2018,38(6):1328-1330.
[10]Khachab H,Brembilla-Perrot B.Prevalence of atrial fibrillation in patients with history of paroxysmal supraventricular tachycardia[J].Int J Cardiol,2013,166(1):221-224.
[11]程征,周子华,陈玺军.普罗帕酮与胺碘酮转复心房颤动效果的Meta分析[J].临床心血管病杂志,2016,32(7):702-706.
[12]曾文军,高彦文,李海涛.普罗帕酮与胺碘酮治疗心律失常效果对比及其对血清hs-CRP的影响[J].山东医药,2015,55(28):42-44.
[13]Kamel H,Elkind MS,Bhave PD,et al.Paroxysmal supraventricular tachycardia and the risk of ischemic stroke[J].Stroke,2013,44 (6):1550-1554.
[14]徐加红.静脉注射普罗帕酮治疗阵发性室上性心动过速的疗效[J].心血管康复医学杂志,2015,24(5):561-564.
[15]王会洪,黄鹤,任贻强.参松养心胶囊联合低剂量胺碘酮治疗室性心律失常的疗效分析[J].中国药房,2017,28(21):2926-2929.
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