Duke M
Department of Cardiology, Manchester Memorial Hospital, Connecticut.
Clin Cardiol. 1988 Mar;11(3):132-6. doi: 10.1002/clc.4960110304.
One hundred patients with a 70% or greater reduction of ventricular premature contractions (VPCs) from baseline during 12 weeks of mexiletine therapy were continued on treatment for an additional 9 months. Fifteen patients did not have follow-up examinations. The response of the remaining 85 patients during this extended period of open-label mexiletine administration is described. Holter recordings were scheduled at 3-month intervals during this period. At these examinations, between 69 and 80% of patients maintained the same 70% or greater level of VPC suppression observed at the start of the 9-month treatment period. Mean and median levels of VPCs/h at each examination were significantly reduced from premexiletine levels throughout the study (p less than 0.0001). Blood tests and electrocardiographic intervals did not vary. The most frequently used dosage of mexiletine during each 3-month treatment period was 600 mg/day (50.0-55.6% of patients). Side effects warranted discontinuation of therapy in 8% (8/97) of patients, while in 25% (22/85), clinical evaluation resulted in a change in dosage level. Within a setting similar to that of clinical practice, long-term mexiletine administration for non-life-threatening ventricular arrhythmias was effective and well tolerated.
100例在美西律治疗12周期间室性早搏（VPC）较基线水平减少70%或更多的患者继续接受治疗9个月。15例患者未进行随访检查。本文描述了其余85例患者在美西律开放标签给药的延长期内的反应。在此期间，动态心电图记录每3个月安排一次。在这些检查中，69%至80%的患者维持在9个月治疗期开始时观察到的相同的70%或更高的VPC抑制水平。在整个研究过程中，每次检查时每小时VPC的平均水平和中位数水平均较美西律治疗前显著降低（p<0.0001）。血液检查和心电图间期无变化。在每个3个月治疗期内，最常用的美西律剂量为600mg/天（占患者的50.0 - 55.6%）。8%（8/97）的患者因副作用而停药，而25%（22/85）的患者经临床评估后调整了剂量水平。在类似于临床实践的环境中，长期使用美西律治疗非危及生命的室性心律失常有效且耐受性良好。
