普罗帕酮和胺碘酮治疗阵发性室上性心动过速疗效与安全性比较

目的 比较普罗帕酮和胺碘酮静脉用于急诊转复阵发性室上性心动过速的疗效及不良反应.方法 将急诊阵发性室上性心动过速患者86例完全随机分成普罗帕酮组(44例)和胺碘酮组(42例),普罗帕酮组给予普罗帕酮70 mg静脉注射(5 min注完),若无效,20min后重复1次;胺碘酮组给予胺碘酮5～7 mg/kg加入100 ml 5%葡萄糖或0.9%氯化钠注射液中静脉滴注,30 min滴完,继之以1 mg/min的速度持续静脉滴注.观察2组的治疗效果和不良反应发生情况.结果 普罗帕酮组和胺碘酮组转复有效率分别为93.2%(41/44)和88.1%(37/42)(P＞0.05);平均转复时间普罗帕酮组(12.4±7.8)min]明显短于胺碘酮组(30.7±10.3)min](P＜0.01);不良反应发生率普罗帕酮组为29.5%(13/44)]明显高于胺碘酮组11.9%(5/42)](P＜0.05).结论 普罗帕酮和胺碘酮用于急诊转复阵发性室上性心动过速,疗效基本相同,但普罗帕酮起效快,更适用于无器质性心脏疾患者,胺碘酮用于有器质性心脏疾患者较普罗帕酮相对安全.

Comparison of the efficacy and safety of propafenone and amiodarone in the treatment of paroxysmal supraventricular tachycardia

Objective To evaluate the efficacy and safety of propafenone and amiodarone in the treatment of paroxysmal supraventricular tachycardia(PSVT). Methods Total 86 cases of PSVT were randomly divided into propafenone group and amiodarone group. Propafenone group had intravenously injected 70 mg propafenone. The intravenous injections lasted 5 minutes. Amiodarone group were intravenously infused amiodarone(5-7 mg/kg) (the intravenous infusion lasted 30 minutes). Results The termination rate of PSVT was 93.2% in propafenone group and 88.1% in amiodarone group respectively. Cardioversion time showed as follows: propafenone group(12.4 ±7.8 min) was significantly shorter than amiodarone group (30.7 ± 10.3) min (P ＜ 0.01). Side reaction showed that propafenone group(29.5%) was significantly higher than amiodarone group (11.9%) (P ＜ 0.05). Conclusions The effective cardioversion rates of propafenone and amiodarone in treating PSVT are high in emergency department.Propafenone shows faster effect and higher side effects but better outcome for patients without serious organic heart diseases than Amiodarone which is better for patients with serious organic heart diseases.