临床荟萃

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静脉注射艾司洛尔治疗慢性阻塞性肺疾病合并快速心房颤动的疗效及安全性

  

  1. 清华大学第一附属医院 呼吸内科,北京 100016
  • 出版日期:2018-01-05 发布日期:2018-01-22
  • 通讯作者: 通信作者:崔蓉, Email: cuirong9999@sina.com

Efficacy and safety of intravenous injection of esmololin in treatment of chronic obstructive pulmonary disease  with rapid atrial fibrillation

  1. Department of Respiratory Medicine, the First Affiliated Hospital of Tsinghua University, Beijing  100016, China
  • Online:2018-01-05 Published:2018-01-22
  • Contact: Corresponding author: Cui Rong, Email: cuirong9999@sina.com

摘要: 目的  观察静脉注射艾司洛尔治疗慢性阻塞性肺疾病(COPD)合并快速心房颤动的临床疗效及安全性。方法 COPD急性加重合并快速心房颤动患者共58例,其中25例给予静脉注射艾司洛尔序贯口服倍他乐克,33例给予静脉注射胺碘酮序贯口服胺碘酮,观察两组心律失常疗效及对血压、心率、动脉血气的影响。结果 两组分别静脉注射艾司洛尔及胺碘酮后,心律失常明显减少,两组有效率分别为92.0%和93.9%,两组均会导致血压下降,但不需使用血管活性药物维持血压;艾司洛尔组未出现严重不良反应,胺碘酮组有2例出现严重心动过缓(<50次/min),退出临床观察。治疗过程中两组呼吸衰竭没有明显加重。结论 艾司洛尔在COPD合并快速心房颤动治疗中安全有效,可有效控制心室率,不会导致呼吸衰竭加重。

关键词: 肺疾病, 慢性阻塞性, 心律失常, 心性, 心房颤动, 肾上腺素能&beta, 受体拮抗剂

Abstract: Objective   To observe the clinical efficacy and safety of intravenous injection of Esmolol in the treatment of chronic obstructive pulmonary disease(COPD) with rapid atrial fibrillation. Methods   A total of 25 COPD patients with rapid atrial fibrillation were treated with intravenous injection of esmolol and sequentially with oral betaloc, and 33 cases of the control group were given intravenous injection of amiodarone and sequential oral amiodarone. The therapy effects on arrhythmia, blood pressure, heart rate and arterial blood gas were observed between two groups.Results  After the intervention group and control group were intravenously injected with esmolol and amiodarone respectively, the arrhythmia was significantly reduced with the difference of 92% vs 93.9% in the effective rate. Both groups resulted in decreased blood pressure but there were no need to use vasoactive drugs to maintain. For the safety, there were no severe adverse events in the intervention group. In the control group, two patients with amiodarone experienced severe bradycardia (<50 beats/min). There were no notable exacerbations in respiratory failure between two groups.Conclusion  Esmolol is safe and effective in the treatment of COPD with rapid atrial fibrillation, which can effectively control the ventricular rate and will not lead to respiratory failure exacerbations.

Key words: pulmonary disease, chronic obstructive; arrhythmias, cardiac; atrial fibrillation;adrenergic betaantagonists