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胺碘酮 普罗帕酮对QTc离散度的影响比较及其临床意义 |
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刘圳奋 尹虹
【摘要】 目的 比较胺碘酮(27例)和普罗帕酮(34例)分别治疗室性心律失常前后QTc离散度(QTcd)的变化及对复发的影响。方法 采用随机、单盲的方法，测定两组病人用药前及用药2周后的QTcd。结果 (1)胺碘酮组用药后QTc明显延长，但QTcd反而降低(44.3±14.9ms与33.9±16.1ms,P<0.05)；普罗帕酮组用药前后QTc及QTcd无显著变化(P均>0.05)。(2)胺碘酮组和普罗帕酮组的有效率分别为85.2%和82.4%(P>0.05)；停药后1月内的室性心律失常复发率分别为18.5%和50%(P<0.05),普罗帕酮组复发者较未复发者的QTcd明显延长(48.7±15.3ms与39.8±12.5ms，P<0.01)。结论 QTcd的降低可能是胺碘酮治疗室性心律失常复发率较低的重要因素。
【关键词】 胺碘酮 普罗帕酮 QTc离散度
Comparative analysis and its clinical significance of amiodarone and propafenone on QTc dispersion Liu Zhenfen,Yin Hong. Department of Cardiology,Lanzhou First Hospital,Lanzhou 730050
【Abstract】 Objective To compare the effects of amiodarone and propafenone on variation of QTc dispersion (QTcd) in the patients with recurrent ventricular arrhythmias.Methods A random, single-blind and respective study was performed in 61 patients. The QTcd were measured before and two weeks after the treatments of amiodarone (n=27) and propafenone (n=34). Results (1) The QTc in amiodarone group was obviously increased but QTcd was decreased on the contrary (44.3±14.9ms vs 33.9±16.1ms, P<0.05). No significant differences of QTc and QTcd were found in propafenone group (P>0.05, respectively); (2)The effective rates of amiodarone and propafenone groups were 85.2% and 82.4% respectively (P>0.05) but the recurrent rates of ventricular arrhythmias were 18.5% and 50% respectively (P<0.05) in one month after withdrawal of drugs. In propafenone group, QTcd in patients with recurrent ventricular arrhythmias were significantly increased than those of controls (48.7±15.3ms vs 39.8±12.5ms,P<0.01). Conclusion The decrease of QTcd was probably an important factor of lower recurrent rate of ventricular arrhythmias after amiodarone treatment.
【Key words】 amiodarone propafenone QTc dispersion
依据改良的Williams分类法，胺碘酮与普罗帕酮分别属于Ⅲ类和Ⅰc类抗心律失常药物。二[1] [2] [3] 下一页
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