中国临床实用医学
中國臨床實用醫學
중국림상실용의학
CHINA CLINICAL PRACTICAL MEDICINE
2010年
4期
12-14
,共3页
依布利特%脑栓塞%心房纤颤%心律转复
依佈利特%腦栓塞%心房纖顫%心律轉複
의포리특%뇌전새%심방섬전%심률전복
Ibutilide%Cerebral embolism%Atrial fibrillation%Cardioversion
目的 评价新型Ⅲ类抗心律失常药物依布利特转复脑栓塞并心房纤颤(房颤)患者的有效性和安全性.方法 本研究选择脑栓塞并房颤持续1 h～90 d的患者40例,其中男24例,女16例,10min内静脉注射依布利特1 mg,如给药结束10 min后仍未转复为窦性心律,重复前述治疗1次.观察开始给药后90 min内房颤的转复率及4 h内的不良反应.结果 ①依布利特转复脑栓塞房颤的成功率高(77.5%,31/40);②脑栓塞房颤的转复率与房颤的持续时间有关,持续时间低于24 h的房颤转复率(89.29%,25/28)明显高于持续时间超过24 h者(50%,6/12,P<0.05);③脑栓塞房颤的转复率与左心房直径呈负相关,左心房直径<4.0 cm患者的转复率(92%,23/25)明显高于左心房直径≥4.0 cm患者的转复率(53.33%,8/15,P<0.05);④脑栓塞房颤的转复率与脑栓塞严重程度和基础疾病有关;⑤依布利特的不良反应:消化道症状,1例出现恶心(2.5%,1/40),1例发生非持续性单形室性心动过速,发生率为(2.5%,1/40),均未经特殊处理很快消失,未发现有低血压及长间歇.结论 依布利特是一种转复房颤的抗心律失常药物,能有效、快速、安全的转复脑栓塞患者的心房纤颤.
目的 評價新型Ⅲ類抗心律失常藥物依佈利特轉複腦栓塞併心房纖顫(房顫)患者的有效性和安全性.方法 本研究選擇腦栓塞併房顫持續1 h～90 d的患者40例,其中男24例,女16例,10min內靜脈註射依佈利特1 mg,如給藥結束10 min後仍未轉複為竇性心律,重複前述治療1次.觀察開始給藥後90 min內房顫的轉複率及4 h內的不良反應.結果 ①依佈利特轉複腦栓塞房顫的成功率高(77.5%,31/40);②腦栓塞房顫的轉複率與房顫的持續時間有關,持續時間低于24 h的房顫轉複率(89.29%,25/28)明顯高于持續時間超過24 h者(50%,6/12,P<0.05);③腦栓塞房顫的轉複率與左心房直徑呈負相關,左心房直徑<4.0 cm患者的轉複率(92%,23/25)明顯高于左心房直徑≥4.0 cm患者的轉複率(53.33%,8/15,P<0.05);④腦栓塞房顫的轉複率與腦栓塞嚴重程度和基礎疾病有關;⑤依佈利特的不良反應:消化道癥狀,1例齣現噁心(2.5%,1/40),1例髮生非持續性單形室性心動過速,髮生率為(2.5%,1/40),均未經特殊處理很快消失,未髮現有低血壓及長間歇.結論 依佈利特是一種轉複房顫的抗心律失常藥物,能有效、快速、安全的轉複腦栓塞患者的心房纖顫.
목적 평개신형Ⅲ류항심률실상약물의포리특전복뇌전새병심방섬전(방전)환자적유효성화안전성.방법 본연구선택뇌전새병방전지속1 h～90 d적환자40례,기중남24례,녀16례,10min내정맥주사의포리특1 mg,여급약결속10 min후잉미전복위두성심률,중복전술치료1차.관찰개시급약후90 min내방전적전복솔급4 h내적불량반응.결과 ①의포리특전복뇌전새방전적성공솔고(77.5%,31/40);②뇌전새방전적전복솔여방전적지속시간유관,지속시간저우24 h적방전전복솔(89.29%,25/28)명현고우지속시간초과24 h자(50%,6/12,P<0.05);③뇌전새방전적전복솔여좌심방직경정부상관,좌심방직경<4.0 cm환자적전복솔(92%,23/25)명현고우좌심방직경≥4.0 cm환자적전복솔(53.33%,8/15,P<0.05);④뇌전새방전적전복솔여뇌전새엄중정도화기출질병유관;⑤의포리특적불량반응:소화도증상,1례출현악심(2.5%,1/40),1례발생비지속성단형실성심동과속,발생솔위(2.5%,1/40),균미경특수처리흔쾌소실,미발현유저혈압급장간헐.결론 의포리특시일충전복방전적항심률실상약물,능유효、쾌속、안전적전복뇌전새환자적심방섬전.
Objective To judge the efficiency and safety of intravenous ibutilide for immediate cardioversion of recent-onset cerebral embolism and atrial fibrillation. Methods Fourty consecutive patients with atrial fibrillation(onset with in 1 h-90 d) and cerebral embolism were selected to the group. Patients received ibutilide 1 mg Ⅳ over 10 min. If atrial fibrillation persisted ten minutes later, repeat the first loading. Results The rate of cardioversion of the ibutilide group was high for up to 77.5%. The conversion rate was higher in patients whose atrial fibrillation had persisted within 24 h than over 24 h (89.29% vs 50%,P<0.05). The efficiency was higher in patients whose left atrial diameter was below 4.0 cm than that over 4.0 cm(92% vs 53.33%,P<0.05). The rate of conversion was related to degree and area of cerebral embolism. Diaorder of digestion is adverse drug reaction of ibutilide. The most serious adverse effect of ibutilide was nonsustained monomiphic yentricular tachycardia. Conclusion Ibutilide is a safe and effective agent cardioversion of recent-onset cerebral embolism and atrial fibrillation.
