静脉应用胺碘酮治疗阵发性房颤36例疗效观察

目的观察静脉应用胺碘酮治疗阵发性房颤的临床疗效。方法将68例阵发性房颤病人随机分为治疗组和对照组，治疗组静脉应用胺碘酮150mg加入生理盐水稀释，于10min静脉注入。转复窦性心律后静脉维持（600μg／min），同时口服胺碘酮，每周5d。第1周600mg／d，第2周400mg／d，第3周200mg／d。对照组用普罗帕酮70mg，加入5％葡萄糖液稀释，5min～10min静脉注入。转复窦性心律后次日口服普罗帕酮200mg，8h口服1次，一周后逐渐减量至150mg／d维持。观察两组转复窦性心律的有效率、不良反应及维持率。结果治疗组转复率为86％，维持率为81％；对照组转复率为84％，维持率为56％。结论胺碘酮与普罗帕酮均可静脉应用于转复阵发性房颤。但胺碘酮在维持窦性心律方面较普罗帕酮更为有效。     

胺碘酮治疗心力衰竭伴室性期前收缩的临床观察

目的探讨胺碘酮治疗心力衰竭伴室性期前收缩的临床疗效。方法应用胺碘酮0．2g，3次／d口服，连服1周，然后改为0．2g，2次／d，连服1周，以后0．1～0．2g／d，1次／d维持治疗，听诊患者的期前收缩次数及观察心电图记录（或心电监护）。结果48例患者中，室性期前收缩次数减少70％以上者36例占75％。结论胺碘酮治疗心力衰竭合并室性期前收缩疗效显著。     

胺碘酮与普罗帕酮对于房颤转复与维持窦律的临床观察

目的观察胺碘酮与普罗帕酮对阵发性快速心房颤动的治疗效果。方法选择144例患者按就诊先后顺序随机分为2组。A组（74例）给予胺碘酮注射液负荷量150mg，静推10min注射完毕，观察10min，未恢复窦性心律或心率仍较快者以0．5～1mg／min维持静脉滴注；复律成功后给予胺碘酮片口服维持窦律。B组（70例）给予普罗帕酮注射液70mg，静推10min注射完毕，观察10min，未恢复窦性心律，重复应用，最大累积量为210mg；复律成功后给予普罗帕酮片口服维持窦律。结果胺碘酮治疗组复律成功率为78．38％，普罗帕酮治疗组复律成功率为51．43％，两组相比差异有统计学意义（P〈0．05）。治疗1、3．6、12个月后胺碘酮组左心房直径渐缩小，E、A及E／A渐提高，使E／A倒置得到恢复。结论胺碘酮和普罗帕酮对阵发性快速房颤均有较高的转复率。胺碘酮复律后窦律维持率高于普罗帕酮，胺碘酮对逆转心房心肌重构安全有效。     

普罗帕酮或胺碘酮联合福辛普利治疗心房颤动的研究

目的评价长期口服低剂量普罗帕酮或胺碘酮联合福辛普利治疗阵发性房颤的疗效及安全性。方法2004年1月～2005年1月在本院门诊及住院就诊的患者，共入选113例阵发性房颤患者，男性60例，女性53例，年龄61．2±5．4（52～72）岁，病程35．7±24．3（3～120）月，其中46例合并高血压，8例合并冠状动脉粥样硬化性心脏病。患者随机分为两组：胺碘酮组（A组）56例，普罗帕酮组（B组）57例。A组，先给予胺碘酮200meg次，3次，d，服用1周；继之200mg／次，2次，d，服用1周；第3周时剂量调整为200meg次，1次，d，以后维持此剂量。B组，给予普罗帕酮150mg／次，3次，d。所有患者均给予福辛普利，高血压患者10mg／d，血压正常者5mg／d。所有患者均随访1年。结果共有94例患者达到随访终点，其中A组46例，B组48例；在随访中，A组用药前1-4次／月，用药后为0．6次／月，p〈0．05，差异有显著性。用药前B组需住院或急诊治疗平均为1．2次／月，用药后为0．9次／月，差异没有显著性。随访结束时，B组复发者24例，47．8％患者仍维持窦律；A组复发者11例，77．1％的患者仍维持窦律，结果明显优于B组（p〈0．01）。A组11例复发者用药前3月平均发作14．2次，用药后3月、6月、9月、12月分别平均发作3．0次、2．6次、2．5次、2．4次，较用药前发作次数均有下降（p值均小于0．05），在随访中没有一例发展为持续性房颤。B组24例复发者用药前3月平均发作18．0次，用药后3月、6月、9月、12月分别平均发作9．5次、10．8次、12．1次、13．5次，较用药前发作次数均有下降（p值均小于0．05），但随着用药时间延长，发作次数呈上升趋势；而且在随访的一年内有3例发展为持续性心房颤动。结论长期低剂量口服普罗帕酮或胺碘酮联合福辛普利均能有效减少阵发性房颤发作的频率，?     

稳心颗粒联合胺碘酮治疗室性期前收缩的临床观察

目的观察稳心颗粒联合胺碘酮治疗室性期前收缩的临床疗效。方法将入选病例60例随机分为2组,治疗组（A组）口服稳心颗粒及胺碘酮片,对照组（B组）口服胺碘酮片,疗程均为4周。结果总有效率A组为93％,B组为87％,二组比较无显著性差异（P〉0．05）,胺碘酮应用总量A组比B组减少1／2,二组比较有显著性差异（P〈0．05）。结论稳心颗粒对室性期前收缩有一定的疗效作用,并可减少胺碘酮的用量。     

稳心颗粒联合胺碘酮治疗室性期前收缩的疗效观察

目的观察稳心颗粒联用胺碘酮治疗室性期前收缩的疗效及安全性。方法选择室性期前收缩患者84例,随机分为稳心颗粒加胺碘酮组（A组）43例,胺碘酮组（B组）41例。A组给予稳心颗粒9g加胺碘酮0.2g,1次/d,饭后服用。B组给予胺碘硐0.2g,3次/d,饭后服用。两组均以4周为1个疗程。治疗前及疗程结束后行24h动态心电图及血常规、肝、肾功能检查。结果两组均可显著减少室性期前收缩的发生。两组患者临床疗效间差异有统计学意义（P〈0.01）。结论稳心颗粒联用胺碘酮可显著减少室性期前收缩的发生,疗效优于单用胺碘酮,同时可以减少胺碘酮等抗心律失常药物的剂量。     

稳心颗粒与胺碘酮治疗室性期前收缩疗效观察

目的观察稳心颗粒与胺碘酮治疗室性期前收缩的临床疗效及安全性。方法选择室性期前收缩病人84例,随机分成治疗组和对照组,每组各42例。治疗组给予稳心颗粒口服,每次9g(1袋),每日3次;对照组给予胺碘酮口服,每次0.2g,每日3次,按病情调整剂量。两组均以4周为1个疗程,观察用药前后临床症状、期前收缩次数及不良反应情况。结果治疗组总有效率为85.7%,对照组总有效率为83.3%,两组比较无统计学意义(P>0.05)。同时,在不良反应方面稳心颗粒明显少于胺碘酮。结论稳心颗粒治疗室性期前收缩有较好的疗效和安全性。     

步长稳心颗粒与胺碘酮治疗室性期前收缩的对比观察

目的比较步长稳心颗粒和胺碘酮治疗室性期前收缩的疗效及安全性。方法90例室性期前收缩患者随机分为稳心颗粒组(45例)和胺碘酮组(45例)。稳心颗粒组患者给予稳心颗粒治疗,胺碘酮组患者给予胺碘酮治疗,均治疗4周。观察用药前后两组患者的临床症状、期前收缩次数及不良反应情况。结果稳心颗粒组患者治疗后总有效率为82.2%,胺碘酮组为80.2%,两组患者治疗后总有效率间差异无统计学意义(P<0.05)。结论稳心颗粒对室性期前收缩的疗效与胺碘酮相当,但不良反应少。     

胺碘酮和普罗帕酮治疗冠心病并室性心律失常的疗效比较

比较胺碘酮和普罗帕酮治疗冠心病心肌缺血患者室性心律失常的疗效。6 9例冠心病心肌缺血合并室性心律失常患者 ,均接受冠心病正规治疗 ,其中 35例同时口服胺碘酮片 (胺碘酮组 ) ,34例口服普罗帕酮片 (普罗帕酮组 ) ,疗程 4周。疗程开始及结束时均行 2 4h动态心电图及 12导联心电图检查。结果 :两组患者用药后 2 4h室性早搏 ,短阵室性心动过速的发作次数均明显减少 (胺碘酮组用药后与用药前比较分别为 2 70 5± 14 77个vs 6 834± 45 2 8个 ,7.4 2± 3.30次vs 1.2 9± 0 .93次 ;普罗帕酮组则分别为 6 712± 3385个vs 396 2± 1983个 ,8.0 5± 3.37次vs4 .2 2± 2 .5 9次 ,P均 <0 .0 1)。胺碘酮组的疗效高于普罗帕酮组 (P <0 .0 1)。两组未见严重副作用。结论 :胺碘酮对冠心病伴室性心律失常的疗效优于普罗帕酮。     

胺碘酮与普罗帕酮维持阵发性心房颤动复律后病人窦性心律的疗效对比

阵发性心房颤动是一种常见的心律失常,目前主张尽可能复律,而维持复律后窦性心律显得尤为重要。本文旨在观察口服胺碘酮、普罗帕酮用于阵发性心房颤动复律后维持窦性心律的疗效和安全性。1资料与方法1.1给药方法将75例病人分为两组,A组37人,B组38人。两组病人均经复律转为窦性心律,复律方法包括药物及电击复律。复律后A组口服胺碘酮200mgTid,5d后减量为200mgBid,5d后减量为200mgQd,口服维持。B组口服普罗帕酮150mg,Tid。1.2观察项目以上病人均进行随访观察,随访时间为服药后1、2、3、4、6个月,6个月后每隔3个月随访一次,此外,如出现不适…     

Patency rate of small caliber fibrous polyurethane vascular prostheses implanted in the dog carotid and femoral artery improved by use of acetylsalicylic acid and dipyridamol

Segments of 3 mm diameter fibrous polyurethane vascular prosthesis of length 3-4 cm were prepared. They were bilaterally implanted in the carotid and femoral arteries of male and female beagles. Four groups consisting of animals receiving either no medication or thrombocyte aggregation drugs were studied: Group A (8 dogs), no medication: group B (19 dogs), 500 mg acetylsalicylic acid (ASA) once daily and 25 mg dipyridamol (DIP) three times daily orally for 6 weeks after the implantation operation; group C (14 dogs), 250 mg ASA and 25 mg DIP three times daily orally for 6 weeks after the implantation operation; group D (12 dogs), 250 mg ASA and 25 mg DIP three times daily orally for 25 weeks after the implantation operation. Medication was started one week prior to the implantation operation. In group A, all prostheses were occluded at week 6. There was a significant difference in patency rates between groups B-D and C-D. No significant differences in patency rates could be found between groups B and C. The best patency rates were obtained 25 weeks after implantation in group D for both the right and left carotid and right and left femoral implantation sites. Highest patency rates were observed when ASA and DIP were given for 25 weeks.     

稳心颗粒治疗阵发性心房纤颤疗效及安全性研究

目的探讨阵发性心房纤颤应用步长稳心颗粒治疗的疗效及安全性。方法选择阵发性心房纤颤住院患者90例,随机分为两组,治疗组45例,对照组45例。两组患者均给予常规治疗。治疗组加用步长稳心颗粒,1包（5g）/次,开水冲服,3次/d;对照组给予胺碘酮片口服,200mg/次,3次/d,1周后改为200mg/次,2次/d,1周后改为200mg/次,1次/d,疗程为8周。结果治疗组与对照组比较,在临床症状改善与心律失常疗效方面,差异无统计学意义（P〉0.05）。结论步长稳心颗粒治疗阵发性心房纤颤耐受性好,安全有效。     

RonT(U)型室性期前收缩诱发快速性室性心律失常

目的　探讨 Ron T( U)型室性期前收缩的类型与快速性室性心律失常的关系。方法　分析 3 1例在入院后发生≥ 1次由 Ron T( U)型室性期前收缩诱发的快速性室性心律失常患者发作时与发作前后的常规 1 2导联心电图或持续心电监视心电图。结果　 3 1例诱发快速性室性心律失常的 Ron T ( U)型室性期前收缩可分为 3种类型 :( 1 ) QT间期正常的非长间歇依赖性 Ron T型室性期前收缩 ;( 2 ) QT间期正常的长间歇依赖性 Ron T型室性期前收缩 ;( 3 )长QT ( U)间期综合征伴 Ron T ( U)型室性期前收缩。各型 Ron T ( U)型室性期前收缩及其所诱发的快速性室性心律失常有不同的临床与心电学特征。结论　 Ron T ( U)型室性期前收缩类型与其所诱发的快速性室性心律失常关系密切     

Omeprazole 10 mg or 20 mg once daily in the prevention of recurrence of reflux oesophagitis. Solo Investigator Group.

This study determined the optimal maintenance dose of omeprazole in reflux oesophagitis. One hundred and ninety three patients rendered asymptomatic and healed after four or eight weeks omeprazole were randomised double blind to 10 mg omeprazole once daily (n = 60 evaluable), 20 mg omeprazole once daily (n = 68), or placebo (n = 62) for one year or until symptomatic relapse. Each omeprazole regimen was superior to placebo in preventing both symptomatic relapse (life table analysis, p < 0.001) and endoscopically verified relapse (p < 0.001). At 12 months, the life table endoscopic remission rates (proportions of patients without grade > or = 2 oesophagitis) were: 50% (95% confidence intervals 34 to 66%) with 10 mg omeprazole once daily, 74% (62 to 86%) with 20 mg omeprazole once daily, and 14% (2 to 26%) with placebo. At 12 months, the life table symptomatic remission rates (proportions of patients asymptomatic or with mild symptoms) were: 77% (64 to 89%) with 10 mg omeprazole once daily, 83% (73 to 93%) with 20 mg omeprazole once daily, and 34% (16 to 52%) with placebo. Both 10 mg and 20 mg omeprazole once daily were effective in prolonging the remission of reflux oesophagitis: 10 mg may be appropriate to start longterm treatment, though the existence of a dose response relation means that 20 mg once daily may be effective in patients for whom 10 mg once daily is suboptimal.     

Esomeprazole 40 mg administered intravenously has similar safety and efficacy profiles to the oral formulation in patients with erosive esophagitis

BACKGROUND/AIMS: An intravenous formulation of esomeprazole has been developed for use in patients where oral administration is not appropriate. This study evaluated safety after 1 and 4 weeks, and efficacy after 4 weeks' esomeprazole 40 mg once daily treatment, administered via an intravenous injection, intravenous infusion or orally, in patients with erosive esophagitis. METHODS: In this double-blind, multi-centre study, patients with endoscopically confirmed erosive esophagitis (Los Angeles grade A-D) were randomized to receive 1 week's treatment of esomeprazole 40 mg once daily, via a 3-min injection, a 30-min infusion or orally, followed by 3 weeks of open treatment with oral esomeprazole 40 mg once daily. Safety variables were evaluated following 1 and 4 weeks' esomeprazole treatment. Healing rates at 4 weeks were estimated. RESULTS: Intravenous and oral esomeprazole were equally well tolerated during the first week, and after 4 weeks' treatment. The 3 treatment groups showed similar levels of healing following 4 weeks' treatment with esomeprazole (injection + oral: 79.7%; infusion + oral: 80.2%; oral alone: 82.6%). CONCLUSIONS: Esomeprazole 40 mg administered via an intravenous injection, intravenous infusion or orally administered for 1 week, followed by 3 weeks of oral dosing, is well tolerated and provides effective healing of erosive esophagitis.     

Comparison of twice-daily stavudine plus once- or twice-daily didanosine and nevirapine in early stages of HIV infection: the scan study

OBJECTIVES: To evaluate the safety and effectiveness of once-daily didanosine and nevirapine plus twice-daily stavudine versus twice-daily administration of all three drugs. METHODS: This open-label, randomized, multicentre study enrolled 94 antiretroviral-naive patients with chronic HIV infection, CD4+ cell counts > 500 x 10(6) cells/l, and viral loads > 5000 copies/ml. Patients were treated with either 40 mg stavudine (twice daily) plus 400 mg didanosine (once daily) and 400 mg nevirapine (once daily) or 40 mg stavudine (twice daily) plus 200 mg didanosine (twice daily) and 200 mg nevirapine (twice daily). RESULTS: After 12 months, 68% of patients who received twice-daily didanosine and nevirapine had viral loads < 200 copies/ml in the intention-to-treat and 79% in the on-treatment analysis, respectively. The corresponding values for patients treated with didanosine and nevirapine, taken once-daily, were 73 and 85%. The percentages of patients in each group with viral loads < 5 copies/ml at 12 months were 40% (once daily ) and 45% (twice daily) for the intention-to-treat analysis. Five of 11 patients (45%) with plasma viral loads < 5 copies/ml at 12 months had detectable virus in tonsillar tissue. Genotypic resistance to nevirapine was noted in seven of the 14 patients with detectable viral load at month 12. Mean changes in CD4+ cell counts for patients treated with stavudine plus once- or twice-daily didanosine and nevirapine were 154 and 132 x 10(6) cells/l, respectively. Treatment was interrupted due to adverse events in seven patients (8%) (four who received once-daily didanosine and nevirapine and three treated with twice-daily doses). CONCLUSIONS: The combination of twice-daily stavudine plus once-daily didanosine and nevirapine was as safe and well tolerated as twice-daily administration of all three agents. Both regimens were equally effective in reducing viral loads and in increasing CD4+ cell counts.     

Comparative study of a slow-release quinidine preparation and flecainide administered in 2 daily doses for the treatment of extrasystole

The new anti-arrhythmic agent flecainide was compared in a single-blind cross-over study to arabogalactane quinidine sulfate in the treatment of stable chronic extrasystole, using a fixed twice-daily dose protocol. Results were assessed by the Holter method. 12 patients (7 men and 5 women) with an average age of 56.5 were selected on the basis of stable and essentially ventricular extrasystole (VES) in 11 cases, and essentially atrial extrasystole (AES) in the remaining case. All patients however had some VES and 6 had some AES, and 5 patients had bursts of VES. The protocol provided for four sequences lasting one week each: one fixed, for selection, and the other three random, flecainide (375 mg), quinidine (660 mg), or placebo (2 doses). Data on each were recorded for Holter analysis. Statistical comparison of results was performed by studying variances on an equilibrated block. Comparison between the selection and placebo sequences showed the stability of the arrhythmia whatever its type. Against ectopic complexes as a whole, only flecainide had significant activity (p less than 0.01). Against AES, both compounds were active (p less than 0.05), quinidine more than flecainide (-73%/63%: a non-significant difference). Only flecainide was active against VES (-88.5%). Quinidine did not significantly reduce VES (-56%).(ABSTRACT TRUNCATED AT 250 WORDS)     

Comparative evaluation of four therapeutic regimes in chikungunya arthritis: a prospective randomized parallel-group study

ObjectiveTo evolve a treatment protocol for patients presenting in acute stage of chikungunya by identifying the best regimen from four treatment regimes.Materials and methodsOne hundred and twenty patients diagnosed to have chikungunya arthritis clinically were randomized to one of four groups receiving combinations of aceclofenac (200 mg/day), hydroxychloroquine (400 mg/day) and prednisolone (10 mg/day). Group A received aceclofenac alone; Group B received aceclofenac plus hydroxychloroquine; Group C received aceclofenac and prednisolone and Group D, all three agents. Study medications were given for 6 weeks with weekly follow-ups followed by a 6 weeks drug-free follow-up with visits at week 8 and week 12. Efficacy variables including visual analog scale (VAS) for pain, 20-point modified Barthel index for activities of daily living (ADL) and instrumental activities of daily living (IADL) were assessed and recorded during start of therapy and at all follow-up visits.ResultsSignificant (P < 0.001) reduction in VAS scores and improvement in ADL and IADL scores were observed in groups C and D compared to groups A and B. Between groups A and B there was no significant difference; similarly, between groups C and D also there was no significant difference.ConclusionAddition of prednisolone, and not hydroxychloroquine, to aceclofenac reduced pain and improved the quality of life in patients with acute chikungunya arthritis, compared to aceclofenac given alone in the management of early chikungunya fever. We propose a combination of non-steroidal anti-inflammatory drugs with corticosteroid as the best regimen in treating acute chikungunya cases with arthralgia.     

Early vasodilator treatment in myocardial infarction: appropriate for the majority or minority?

OBJECTIVE--To assess the influence of vasodilator treatment started early after myocardial infarction on left ventricular size and function. SETTING--Coronary care unit, Royal Infirmary, Edinburgh. PATIENTS--105 patients with acute myocardial infarction (systolic blood pressure > 90 mm Hg) were randomised within 24 hours of the start of pain. Unlike previous studies 88% of the patients received thrombolysis. METHODS--Double blind randomised placebo controlled study with either 12.5 mg of captopril three times daily or 20 mg of isosorbide mononitrate three times daily for 28 days. MAIN OUTCOME MEASURES--Clinical outcome and left ventricular size and function assessed by echocardiography, radionuclide ventriculography, and magnetic resonance imaging. RESULTS--There was no difference in left ventricular size or function in either treatment group as measured one week after the end of the trial. Even the placebo group tended to decrease left ventricular diameter over the four week study period (one week: 5.0 (0.1) v, five weeks: 4.8 (0.1) cm, NS). Four patients had an adverse clinical outcome in the placebo group whereas no adverse outcome was seen in the captopril group. CONCLUSIONS--Vasodilator treatment may be of limited value or of no benefit for most infarct patients, particularly those treated with thrombolytic agents. Captopril, however, may benefit patients at high risk.     

Risedronate Once A Week

Risedronate (risedronic acid), an orally administered pyridinyl bisphosphonate, inhibits osteoclast-mediated resorption of bone and modulates bone metabolism in women with postmenopausal osteoporosis. The long terminal exponential half-life of risedronate (480 hours) has led to the development of a 35mg tablet for once-a-week administration. The beneficial effects of risedronate 35mg once a week on total hip, femoral neck and trochanter bone mineral density (BMD) at 12 months were similar to those of risedronate 5mg once daily. Risedronate 35mg once a week was as effective as risedronate 5mg once daily in improving lumbar spine BMD in a randomized, double-blind, multicenter trial of 1456 women with postmenopausal osteoporosis. Mean percentage increases in BMD from baseline at 12 months were 3.94% and 4.25% in the 35mg and 50mg once-a-week dose groups, compared with 4% in the 5mg once-daily dose group. The differences between the once-a-week doses and the once-daily dose met the predetermined criterion for non-inferiority. An historical analysis suggested that risedronate 35mg once a week reduced the incidence of vertebral fracture significantly more than placebo. The tolerability profile (including the incidence of upper gastrointestinal adverse events) of risedronate 35mg once a week in women with postmenopausal osteoporosis, was similar to that of risedronate 5mg once daily.