伊布利特和胺碘酮在永久性心脏起搏器植入术后新发心房颤动中的应用疗效和安全性对比

摘要/Abstract

摘要： 目的探讨与对比伊布利特和胺碘酮在永久性心脏起搏器植入术后新发心房颤动中的应用疗效和安全性。方法选择2019年1月~2022年3月在宁夏回族自治区人民医院诊治的永久性心脏起搏器植入术后新发房颤患者88例,采用随机数表法把患者分为对照组与联合组,每组44例。对照组给予胺碘酮治疗,联合组在对照组治疗的基础上给予伊布利特治疗,两组均治疗7 d。对比两组治疗1 h内的转复率与转复时间,治疗前后QT间期与Tpeak-end/QT间期变化,治疗后7 d总有效率,治疗后7 d内房颤复发率,治疗后7 d的不良反应发生情况。结果与对照组相比,联合组转复率更高,转复时间更短,差异有统计学意义（P<0.05）。治疗前,联合组与对照组QT间期与Tpeak-end/QT间期对比,差异无统计学意义（P>0.05）;治疗后,联合组2 h的QT间期与Tpeak-end/QT间期与治疗前对比,差异无统计学意义（P>0.05）;而对照组QT间期与Tpeak-end/QT间期治疗前后比较,差异有统计学意义（P<0.05）;联合组治疗后上述两组指标显著低于对照组,差异有统计学意义（P<0.05）。治疗后7 d联合组的总有效率为97.73%,显著高于对照组的84.09%,但差异无统计学意义（P>0.05）。治疗后7 d,联合组的房颤复发率4.54%,对照组的房颤复发率为2.27%,组间对比差异无统计学意义（P>0.05）。联合组治疗后7 d的一过性窦房阻滞、低血压、窦性心动过缓、房室传导阻滞等不良反应发生率为4.54%,显著低于对照组的22.73%,差异有统计学意义（P<0.05）。结论伊布利特联合胺碘酮在永久性心脏起搏器植入术后新发房颤中的应用能提高转复率,加快转复时间,术后房颤复发率较低,不良反应可控,值得临床应用。

关键词: 伊布利特, 胺碘酮, 永久性心脏起搏器植入术, 房颤, 转复率, 心电图, 不良反应

Abstract: Objective To investigate and compare the efficacy and safety of ibutilide and amiodarone in the treatment of new-onset atrial fibrillation after permanent cardiac pacemaker implantation. Methods From January 2019 to March 2022, A total of 88 patients with new-onset atrial fibrillation after permanent cardiac pacemaker implantation who were diagnosed and treated in our hospital from were selected as the research subjects, and the patients were divided into the control group and the combined group accorded to the simple allocation principle with 44 cases in each group. The control group was given amiodarone treatment, and the combined group was given ibutilide treatment on the basis of the treatment of the control group. The two groups were treated for 7 days. The conversion rate and conversion time within 1 hour of treatment, the changes of QT interval and Tpeak-end/QT interval before and after treatment, the total effective rate at 7 days after treatment, the recurrence rate of atrial fibrillation within 7 days after treatment and the occurrence of adverse reactions at 7 days after treatment were compared between the two groups. Results Compared with the control group, the combined group had higher cardioversion rate and shorter cardioversion time, and the differences were statistically significant(P<0.05). There was no significant difference in the QT interval and Tpeak-end/QT interval between the two groups before treatment (P>0.05).After treatment, there was no significant difference in QT interval and Tpeak-end/QT interval at 2 h in the combination group compared with before treatment (P>0.05), but the QT interval and TPEak-END /QT interval of the control group were significantly different before and after treatment (P<0.05), and the above indexes of the combined group were significantly lower than those of the control group after treatment (P<0.05). After 7 days of treatment, the total effective rate of the combined group was 97.73%, which was significantly higher than 84.09% of the control group,but there was no significant difference (P > 0.05). After treatment for 7 d, the recurrence rate of AF in the combined group was 4.54%, and that in the control group was 2.27%, and there was no significant difference between the two groups (P>0.05).The incidence rates of transient sinus block, hypotension, sinus bradycardia, atrioventricular block and other adverse reactions in the combined group 7 days after treatment was 4.54%, which was significantly lower than 22.73% in the control group (P<0.05). Conclusion The application of ibutilide combined with amiodarone in the treatment of new-onset atrial fibrillation after permanent pacemaker implantation can improve the conversion rate and speed up the conversion time, the recurrence rate of postoperative atrial fibrillation is low and the adverse reactions are controllable, which is worthy of clinical application.

Key words: ibutilide, amiodarone, permanent pacemaker implantation, atrial fibrillation, conversion rate, electrocardiogram, adverse reactions

中图分类号:

R541.7+5

马丽娜, 孟婷, 蒋庆军, 李伏, 席少静. 伊布利特和胺碘酮在永久性心脏起搏器植入术后新发心房颤动中的应用疗效和安全性对比[J]. 中华养生保健, 2022, 40(22): 56-59.

MA Li-na, MENG Ting, JIANG Qing-jun, LI Fu, XI Shao-jing. Comparison of Efficacy and Safety of Ibutilide and Amiodarone in the Treatment of New-Onset Atrial Fibrillation after Permanent Pacemaker Implantation[J]. ZHONGHUA YANGSHENG BAOJIAN, 2022, 40(22): 56-59.

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