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[注射用和口服普罗帕酮治疗房室结折返和心室预激传导途径]

[Injectable and oral propafenone in nodal reentry and pathways of ventricular preexcitation].

作者信息

Fauchier J P, Cosnay P, Moquet B, Rouesnel P, Kapusta P, Vrancea F

出版信息

Arch Mal Coeur Vaiss. 1986 Sep;79(10):1506-14.

PMID:3099684
Abstract

Propafenone, an antiarrhythmic drug of IC type, was applied to 10 patients with supraventricular tachycardia (SVT) produced by intranodal reentry (group I) and in 14 patients with reentry by an accessory atrioventricular (AV) pathway (group II), 10 of them suffering from orthodromic SVT. Propafenone given intravenously depresses or blocks the antegrade or retrograde conduction in the AV node and in the accessory AV pathway. The same effect is observed with orally given propafenone: 66% of antegrade blocking and 54% of retrograde blocking of the accessory conduction pathway. Intravenously given propafenone reduces within 2 to 3 min by antegrade or retrograde blocking 70% of SVT produced by intranodal reentry and by 85% of SVT produced by reentry by the accessory pathway. After injection it becomes impossible to induce intranodal SVT in 60% of cases and SVT by the accessory pathway reentry in 28% of cases. With oral treatment (600 mg/day) reinduction of intranodal SVT becomes impossible in 66% of cases and of SVT produced by reentry by the accessory pathway in 42% of cases. Long-term oral administration (17 +/- 3.7 months) of the same dose prevents 88% of SVT produced by internodal reentry and 80% of spontaneous SVT produced by reentry by the accessory pathway. Cardiologic tolerance is satisfactory: one case of atrioventricular and intraventricular dysrhythmia is observed. The same holds true for general tolerance: in 2 cases drug administration is discontinued and 11 patients present neurologic and digestive troubles improving after lowering the dosage or increasing the fractionation.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

普罗帕酮,一种Ic类抗心律失常药物,应用于10例由结内折返引起室上性心动过速(SVT)的患者(I组)以及14例由房室(AV)旁道折返引起SVT的患者(II组),其中10例为顺向型SVT。静脉注射普罗帕酮可抑制或阻断房室结及房室旁道的前向或逆向传导。口服普罗帕酮也有同样效果:旁道传导前向阻滞率为66%,逆向阻滞率为54%。静脉注射普罗帕酮通过前向或逆向阻滞,在2至3分钟内可使70%由结内折返引起的SVT及85%由旁道折返引起的SVT得到控制。注射后,60%的病例无法诱发出结内SVT,28%的病例无法诱发出旁道折返性SVT。口服治疗(600毫克/天)后,66%的病例无法再次诱发出结内SVT,42%的病例无法诱发出旁道折返性SVT。长期口服相同剂量(17±3.7个月)可预防88%由结间折返引起的SVT及80%由旁道折返引起的自发性SVT。心脏耐受性良好:仅观察到1例房室及室内心律失常。总体耐受性也较好:2例停药,11例患者在降低剂量或增加给药次数后神经及消化系统症状有所改善。(摘要截选至250字)

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