Fracalossi C, Ziacchi V, Farisè F, Rossi A, Marino A, Lomanto B, Moretti L
Divisione di Cardiologia, Ospedale di Desenzano sul Garda (Brescia).
G Ital Cardiol. 1989 Jan;19(1):46-52.
Ventricular arrhythmias complicating chronic obstructive pulmonary disease, when refractory to the correction of acidosis and hypoxia, may lead to a poor prognosis. Mexiletine efficacy was assessed in 14 patients (pts.) with chronic obstructive pulmonary disease and premature ventricular contractions; they entered a cross-over trial consisting of 7-day therapy with oral placebo and mexiletine (200 mg q.i.d.). The hourly means of premature ventricular contractions, their hourly peaks and the severity scores of arrhythmias were compared. The analysis of linear regression showed a slight spontaneous variability of premature ventricular contractions in the study group. Unexpectedly, the highly homogeneous data raised the question if this method of evaluation for anti-arrhythmic therapy reaches a satisfactory conclusion. Nevertheless, treatment with mexiletine significantly reduced the premature ventricular contractions count and their hourly peak (p less than 0.001) as well as their severity score (p less than 0.001). Analysis of linear regression and confidence intervals confirmed the efficacy of the drug. According to the statistical method used, antiarrhythmic therapy with mexiletine generally achieved its purpose in pts. with chronic obstructive pulmonary disease.
慢性阻塞性肺疾病并发的室性心律失常，在对酸中毒和缺氧的纠正无效时，可能导致预后不良。对14例患有慢性阻塞性肺疾病和室性早搏的患者评估了美西律的疗效；他们进入了一项交叉试验，该试验包括口服安慰剂和美西律（200毫克，每日4次）的7天治疗。比较了室性早搏的每小时平均值、每小时峰值和心律失常的严重程度评分。线性回归分析显示研究组室性早搏有轻微的自发变异性。出乎意料的是，高度同质的数据提出了一个问题，即这种抗心律失常治疗的评估方法是否能得出令人满意的结论。尽管如此，美西律治疗显著减少了室性早搏的数量及其每小时峰值（p<0.001）以及严重程度评分（p<0.001）。线性回归分析和置信区间证实了该药物的疗效。根据所使用的统计方法，美西律抗心律失常治疗在患有慢性阻塞性肺疾病的患者中总体上达到了目的。
