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目的对比观察普罗帕酮、胺碘酮治疗和预防阵发性心房颤动(PAF)的疗效和安全性。方法对80例阵发性心房颤动患者随机应用普罗帕酮(32例)、胺碘酮(28例)和安慰剂(20例)治疗及预防复发,治疗不少于3个月。结果三组服药后48h内转复率分别为72.7%、42.1%、23.1%,普罗帕酮组显著高于胺碘酮组和安慰剂组(P<0.05和P<0.01);随访(21.6±8.0)个月,总有效率分别为62.5%、71.4%、15.0%,两药物治疗组疗效差异无统计学意义(P>0.05),均明显优于安慰剂组(P<0.01);在随访期限>12个月的病例中,胺碘酮组有效率显著高于普罗帕酮组(P<0.05),表明胺碘酮预防阵发性心房颤动复发的远期疗效优于普罗帕酮。普罗帕酮组和胺碘酮组的不良反应发生率分别为18.8%和17.9%,对比差异无统计学意义(P>0.05),均未见严重毒副反应及致心律失常作用。结论两药对治疗和预防PFA复发性均有较好疗效,且相对安全,胺碘酮的短期复律疗效低于普罗帕酮,但预防PAF复发的远期疗效优于普罗帕酮。
Objective To compare the efficacy and safety of propafenone and amiodarone in the prevention and treatment of paroxysmal atrial fibrillation (PAF). Methods 80 patients with paroxysmal atrial fibrillation were randomized to receive propafenone (32 cases), amiodarone (28 cases) and placebo (20 cases) to treat and prevent relapse for at least 3 months. Results The recovery rates of the three groups were 72.7%, 42.1% and 23.1% within 48 hours after treatment, respectively, which were significantly higher in the propafenone group than in the amiodarone group and the placebo group (P <0.05 and P <0.01) (P <0.01). The total effective rates were 62.5%, 71.4% and 15.0% respectively. There was no significant difference between the two drug treatment groups (P> 0.05) Amiodarone group was significantly more effective than propafenone group (P <0.05), suggesting that long-term efficacy of amiodarone in preventing recurrence of paroxysmal atrial fibrillation was superior to propafenone. The adverse reactions of propafenone group and amiodarone group were 18.8% and 17.9%, respectively, with no significant difference (P> 0.05). No serious side effects and arrhythmia were observed. Conclusions The two drugs have a good curative effect on the treatment and prevention of recurrent PFA, and are relatively safe. The efficacy of amiodarone on short-term cardioversion is lower than that of propafenone. However, the long-term efficacy of propofol against propafenone is better than propafenone.