摘要
应用口服奎尼丁转复心房颤动(AF)393例次,评价其效果、安全性、血药浓度的意义及相关因素对转复的影响。奎尼了用量第1日每次0.2g,每2h1次,共5次。如未能转复逐日每次递增0.1g,至第3日仍未转复逐停药。有47例测了血药浓度。393例次AF中324例次(82.4%)转复成功,平均转复时间为13.7±5.1(2~42)h。高血压病、冠心病、心肌病及孤立性AF的转复率较风湿性心脏病者为高(93.8%、88.9%、88.9%、95.7%vs76.4%,P<0.05)。AF持续时间<6个月者转复率高于6~12及>12个月者(88.2%vs69.2%、56.3%,P<0.01)。左房内径<50mm者转复率高于≥50mm者(89.7%vs72.0%,P<0.05)。有效见药浓度为1.5~6.0ng/ml。未发现与奎尼丁有关的严重副作用。表明口服奎尼丁转复AF的成功率高,严重不良反应的发生率低,其仍不失为治疗AF的一种较好方法。
To evaluate the efficacy,safety and utility of quinidine for cardioversion of atrial fibrillation (AF),thesignificance of serum-drug concentration and the influence of some factors on quinidine treatment. 393 cases weretreated with quinidine. All the patients took quinidine 3 days:the first day,quinidine 0. 2 g,q2h, 5 times;the secondday,quinidine 0. 3 g,q2h, 5 times and the third day,quinidine 0. 4,q2h, 5 times. The serum-drug concentration ofquinidine was measured in 47 cases. 324 of all 393 cases (82. 4% ) were cardioverted to sinus rhythm. The averagetime of cardioversion was 13. 7±5. 1 (2~42) hours. The successful rates in hypertension,coronary heart desease,myocardiopathy and isolated AF were higher than that in rheumatic heart desease (93. 8 %, 88. 9 %. 88. 9 %, 95. 7 %vs 76. 4 %,respectively,P<0. 05). The patients with short time AF (<6 months ) had a high successful rate thanthat in long time AF patients (6~12 and >12 months,P<0.01 ). The patients with small left atria (<50 mm)were easy to recover sinus rhythm (P<0.05). The serum quinidine level in the successful cases was 1. 5~6 ng/ml. No quinidine-induced syncope happened in this group and no patient died of quinidine cardioversion. Conclusion:Acording to our study,oral quinidine is a good therapeutic method for atrial fibrillaion in our country at presenttime,it is more effective,safe,and less adverse effects.
出处
《中国心脏起搏与心电生理杂志》
1997年第3期122-124,共3页
Chinese Journal of Cardiac Pacing and Electrophysiology
关键词
心房颤动
奎尼丁
药物疗法
Atrial fibrillation Qinidine Cardioversion Factor