摘要：目的：观察胺碘酮治疗不稳定型心绞痛并发心房颤动的疗效及安全性。方法：42例不稳定型心绞痛并发心房颤动患者，随机分为胺碘酮治疗组(21例)和毛花甙C对照组(21例)。治疗组静脉注射胺碘酮150mg，未转复为窦性心律者，重复给予75～150mg，后改为静脉滴注150～450mg；对照组静脉注射毛花甙C0.4～0.8mg。结果：治疗组用药后转复为窦性心律16例(76.2%)，3h内转复者7例，3～8h转复者9例，平均复律时间为6.2h，治疗有效率90.5%；毛花甙C组用药后转复为窦性心律9例(42.9%)，3h内转复者3例，3～8h转复者6例，平均复律时间为5.5h。治疗有效率为76.2%。两组用药后心室率均比用药前明显下降，胺碘酮组平均起效时间为(15±8)min，毛花甙C组平均起效时间为(30±5)min，两组平均起效时间及心率下降幅度差异无统计学意义。两组治疗前后QT间期及不良反应差异无统计学意义。讨论:静脉注射胺碘酮控制不稳定型心绞痛并发心房颤动的作用迅速、安全，其疗效高于毛花甙C。可作为不稳定型心绞痛并发心房颤动的首选药物之一。

    关键词：胺碘酮；不稳定型心绞痛；心房颤动

    Analyzing the Effect of Amiondarone on Unstable Angina Pectoris Complicated with Atrial Fibrillation

    ZHANG Long-keng

    (Lishui Hospital of Nanhai District of Foshan, Guangdong Foshan 528244, China)

    Abstract： Objective:To observe effectiveness and security of amiondarone in treating unstable angina pectoris complication by atrial fibrillation. Method: 42 patients with unstable angina pectoris complication by atrial fibrillation, were compared in a randomized study.21 patients treated with amiodarone (group A) or lanatoside C (group B).Group A was treated with amiodarone intravenously as 150mg period, and followed by 75mg to 150mg if conversion to sinus rhythm failed, and followed by a 150mg to 450mg infusion. Group B was treated with lanatoside C intravenously as 0.4mg or 0.8mg. Result: There were 16 patients in group A conversion to sinus rhythm, 7 patients were conversion in 3 hours, and 9 patients in 8 hours, the onset of action was 6.2 hours, ratio effective was 90.5%. There were 9 patients in group B conversion to sinus rhythm, 3 patients were conversion in 3 hours, and 6 patients in 8 hours, the onset of action was 5.5 hours, ratio effective was 76.2%.The ventricular ratios were significant descending in both groups.The mean onset of action group A was 15±8 minutes, and group B was 30±5 minutes.The onset action and the descending range differences were no significant between two groups. The QT interval and the side effect differences were no significant between before and after treatment in both groups. Conclusion:Intravenous amiondarone controlling unstable angina pectoris complication by atrial fibrillation effective and safe, is better than lanatoside C.Amiondarone can be used as first line drug treating unstable angina pectoris complication by atrial fibrillation. ......