CAJ | 학술논문

目的比较静脉注射地尔硫卓和美托洛尔控制心房颤动(简称房颤)患者快速心窒率的疗效.方法吉林人学第二医院2003年1月至2006年7月收治的48例心室率>120次/min 且收缩压≥100 mmHg的房颤患者分为地尔硫卓组(n=24)和美托洛尔组(n=24).地尔硫卓和美托洛尔的用法分别为10 nag和5 mg静脉注射.记录用药后5 min,10 min,15 min和30 min时的患者的心率和血压.治疗有效的定义为用药30 min后心室率下降至100次/min以下或较用药前的心率下降20%以上或转复为窦性心律.数据比较采用t检验、配对t检验及χ2检验.结果和用药前比较,两种药物在上述各个时间点均能显著降低房颤时的快速心窒率(P<0.01),但除用药后30 min外,其它各时间点地尔硫卓组的心窒率显著低于美托洛尔组(P<0.05).在降低心室率的同时,这两种药物亦使血压有所降低,但两组之间的降压作用差异无统计学意义.两组均未见药物所敛的低血压者.用药后30min,地尔硫卓组和美托洛尔组的治疗有效率分别为91.7%和83.3%(P>0.05).结论静脉注射地尔硫卓10 mg或荚托洛尔5 mg在30 min均能使房颤时的快速心室率显著降低,无以地而硫卓作用更强.
목적 비교정맥주사지이류탁화미탁락이공제심방전동(간칭방전)환자쾌속심질솔적료효.방법길림인학제이의원2003년1월지2006년7월수치적48례심실솔>120차/min 차수축압≥100 mmHg적방전환자분위지이류탁조(n=24)화미탁락이조(n=24).지이류탁화미탁락이적용법분별위10 nag화5 mg정맥주사.기록용약후5 min,10 min,15 min화30 min시적환자적심솔화혈압.치료유효적정의위용약30 min후심실솔하강지100차/min이하혹교용약전적심솔하강20%이상혹전복위두성심률.수거비교채용t검험、배대t검험급χ2검험.결과 화용약전비교,량충약물재상술각개시간점균능현저강저방전시적쾌속심질솔(P<0.01),단제용약후30 min외,기타각시간점지이류탁조적심질솔현저저우미탁락이조(P<0.05).재강저심실솔적동시,저량충약물역사혈압유소강저,단량조지간적강압작용차이무통계학의의.량조균미견약물소렴적저혈압자.용약후30min,지이류탁조화미탁락이조적치료유효솔분별위91.7%화83.3%(P>0.05).결론 정맥주사지이류탁10 mg혹협탁락이5 mg재30 min균능사방전시적쾌속심실솔현저강저,무이지이류탁작용경강.
Objective To compare the effectiveness between dilfiazem and metoprolol administered intra-venously on controlling the ventricular tachy-cardia in patients with atrial fibrillation (AF). Method From Jan-uaxy 2003 to July 2006, 48 AF patients in the Second Hospital, Jilin University, with a ventricular rate > 120 beats per minute and systolic blood pressure > 100 mmHg were enrolled and divided into dihiazem group (10 mg, Ⅳ, n = 24) or metoprolol group (5 mg, Ⅳ, n = 24). Blood pressure and heart rote were re-checked at different inter-vals of 5, 10, 15 and 30 minutes,respectively. Successful treatment was defined as ventricular rate < 100 beat/ min or decrease > 20% of the pre-treatment level, or restoumtion of sinus rhythm. Results Compared with pre-treatment value, a significant deceleration in ventricular response to AF was observed after treatment in both groups at each interval (P < 0.01). However, the ventricular rate in the diltiazem group was significantly lower than that in the metoprolol group (P <0.05) at all intervals but 30 minutes. A slight decrease in blood pressure was ob-served in both groups. The drop of blood pressure between two groups was comparable. The successful treatment at the interval of 30 minutes was achieved in 91.7% of patients in dihiazem group and 83.3% of patients in metopro-lol group (P < 0.05). Conclusions Both diltiazem (10 mg, Ⅳ) and metoproiol (5 mg, Ⅳ) are effective on con-trolling the accelerated ventricular response to AF, in particular, the effect of diltiazem seems much superior to ahat of metoprolol.