Amino Mari, Inokuchi Sadaki, Nagao Ken, Nakagawa Yoshihide, Yoshioka Koichiro, Ikari Yuji, Funakoshi Hiraku, Hayakawa Katsura, Matsuzaki Masakazu, Sakurai Atsushi, Tahara Yoshio, Yonemoto Naohiro, Yaguchi Arino, Morimura Naoto
*Tokai University School of Medicine, Kanagawa, Japan; †Nihon University Surugadai Hospital, Tokyo, Japan; ‡Tokyo Bay Urayasu/Ichikawa Medical Center, Chiba, Japan; §Saitama Red Cross Maebashi Hospital, Saitama, Japan; ¶Nihon University School of Medicine, Tokyo, Japan; ‖National Cerebral and Cardiovascular Center Hospital, Osaka, Japan; **National Center of Neurology and Psychiatry, Tokyo, Japan; ††Tokyo Women's Medical University Hospital, Tokyo, Japan; and ‡‡Yokohama City University Medical Center, Kanagawa, Japan.
J Cardiovasc Pharmacol. 2015 Dec;66(6):600-9. doi: 10.1097/FJC.0000000000000310.
Amiodarone (AMD), nifekalant (NIF), and lidocaine (LID) hydrochlorides are widely used for ventricular tachycardia/fibrillation (VT/VF). This study retrospectively investigated the NIF potency and the differential effects of 2 initial AMD doses (≤150 mg or 300 mg) in the Japanese SOS-KANTO 2012 study population.
From 16,164 out-of-hospital cardiac arrest cases, 500 adult patients using a single antiarrhythmic drug for shock-resistant VT/VF were enrolled and categorized into 4 groups (73 LID, 47 NIF, 173 AMD-≤150, and 207 AMD-300). Multivariate analyses evaluated the outcomes of NIF, AMD-≤150, or AMD-300 groups versus LID group. Odds ratios (ORs) for survival to admission were 3.21 [95% confidence interval (CI): 1.38-7.44, P < 0.01] in NIF and 3.09 (95% CI: 1.55-6.16, P < 0.01) in AMD-≤150 groups and significantly higher than those of the LID group. However, the OR was 1.78 (95% CI: 0.90-3.51, P = 0.10) in AMD-300 group and was not significant than LID group. ORs for 24-hour survival were 6.68 in NIF, 4.86 in AMD-≤150, and 2.97 in AMD-300, being significantly higher in these groups.
NIF and AMD result in similar improvements for 24-hour survival in cardiopulmonary arrest patients, and this suggest the necessity of a randomized control study.
盐酸胺碘酮（AMD）、尼非卡兰（NIF）和利多卡因（LID）被广泛用于治疗室性心动过速/心室颤动（VT/VF）。本研究回顾性调查了在日本SOS-KANTO 2012研究人群中尼非卡兰的效力以及两种初始胺碘酮剂量（≤150mg或300mg）的不同效果。
从16164例院外心脏骤停病例中，纳入500例使用单一抗心律失常药物治疗抗休克VT/VF的成年患者，并分为4组（73例使用利多卡因、47例使用尼非卡兰、173例使用≤150mg胺碘酮、207例使用300mg胺碘酮）。多变量分析评估了尼非卡兰组、≤150mg胺碘酮组或300mg胺碘酮组与利多卡因组的治疗结果。尼非卡兰组入院存活的比值比（OR）为3.21[95%置信区间（CI）：1.38 - 7.44，P < 0.01]，≤150mg胺碘酮组为3.09（95%CI：1.55 - 6.16，P < 0.01），均显著高于利多卡因组。然而，300mg胺碘酮组的OR为1.78（95%CI：0.90 - 3.51，P = 0.10），与利多卡因组无显著差异。尼非卡兰组、≤150mg胺碘酮组和300mg胺碘酮组24小时存活的OR分别为6.68、4.86和2.97，这些组的OR显著更高。
尼非卡兰和胺碘酮在心肺骤停患者24小时存活方面有相似的改善效果，这表明有必要进行一项随机对照研究。
