【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。

    Comparative analysis and its clinical significance ofamiodarone and propafenone on QTc dispersion LiuZhenfen,Yin Hong. Department of Cardiology,Lanzhou First Hospital,Lanzhou 730050

     【Abstract 】 Objective To compare theeffects of amiodarone and propafenone on variation of QTc dispersion (QTcd) in thepatients with recurrent ventricular arrhythmias.Methods A random, single-blind and respective study was performed in 61patients. The QTcd were measured before and two weeks after the treatments of amiodarone(n=27) and propafenone (n=34). Results (1) The QTcin amiodarone group was obviously increased but QTcd was decreased on the contrary (44.3±14.9msvs 33.9±16.1ms, P<0.05). No significant differences of QTc and QTcd were found inpropafenone group (P>0.05, respectively); (2)The effective rates of amiodarone andpropafenone groups were 85.2% and 82.4% respectively (P>0.05) but the recurrent ratesof ventricular arrhythmias were 18.5% and 50% respectively (P<0.05) in one month afterwithdrawal of drugs. In propafenone group, QTcd in patients with recurrent ventriculararrhythmias 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 animportant factor of lower recurrent rate of ventricular arrhythmias after amiodaronetreatment.

     【Key words 】 amiodarone propafenone QTc dispersion

     ......