【摘要】 目的 探讨胺碘酮与洋地黄在治疗快速房性心律失常的作用机制及安全性的比较。方法 226例因心血管疾病合并快速房性心律失常住院的病人，随机分为胺碘酮组122例：胺碘酮首次静脉负荷剂量5mg/kg，1h内静脉滴注，其后0.4～0.6mg/min维持，24h总剂量700～1000mg。复律后改为口服400～600mg/d，共5～7天，并酌情逐步减量维持。洋地黄组104例：毛花甙C 0.4mg用生理盐水40ml稀释后静脉缓慢注射,30min无效者加用0.2mg生理盐水20ml稀释后静脉缓慢注射, 30min后仍无效者再追加0.2mg,24h总剂量不大于1.2mg，每次应用时间不少于15min。复律或心室率减慢后，改为口服地高辛0.125～0.25mg /d。 结果 在胺碘酮组与洋地黄组比较中，阵发性房颤、房扑两组差异有显著性(P<0.005)，而持续性房颤、房扑两组比较差异无显著性(P>0.05)。对缺血性心脏病合并快速房性心律失常的患者，胺碘酮疗效满意(P<0.05)。结论 在阵发性房颤、房扑治疗中，胺碘酮组复律显著，是理想的治疗选择。在持续性房颤、房扑治疗中，两组疗效差异无显著性，表明胺碘酮以复律为主，兼有降低心室率作用。洋地黄制剂可降低心室率，改善症状。应用洋地黄制剂后的转复，可能与自动转复有关，不宜把洋地黄制剂看作为复律药物。

    【关键词】 胺碘酮；洋地黄；快速房性心律失常

    Analysis of the effect between amiodarone and digitalisin the therapy of atrial tachyarrhythmias

    CHAI Pei-fang.Beizhan Hospital, Shanghai 200070,China

    【Abstract】 Objective To investigate the efficacy and safety of treatment on atrial tachyarrhythmias with amiodarone and digitalis.Methods 226 patients in cardiovascular disease with atrial tachyarrhythmias, were divided into amiodarone group (122 cases): the first loading dose of 5mg/kg of amiodarone was given within 60 minutes infusion; and digitalis group (104 cases): intravenous loading dose 0.4mg of lanatoside C was given slowly.Results There is very significant difference between amiodarone group and digitalis group in paroxysmal atrial fibrillation or atrial flutter(P<0.005),while there was no significant difference between amiodarone group and digitalis group in permanent atrial fibrillation or atrial flutter(P>0.05).Conclusion Cardioversion of amiodarone group has a significant effect in treating paroxysmal atrial fibrillation or atrial flutter,so it is a useful means.Digitalis can only be used to reduce the ventricle rate. It isn’t appropriate to use it as a cardioversion agent. ......