Hession M J, Lampert S, Podrid P J, Lown B
Harvard School of Public Health, Boston, Massachusetts 02115.
Am J Cardiol. 1987 Oct 16;60(11):59F-66F. doi: 10.1016/0002-9149(87)90723-5.
Moricizine HCl (Ethmozine), a new antiarrhythmic agent, was administered to 102 patients with refractory ventricular fibrillation (n = 31), sustained ventricular tachycardia (VT) (n = 46) or symptomatic nonsustained VT (n = 25). A noninvasive approach utilizing monitoring and exercise testing was used in 82 patients who had a high density of reproducible spontaneous arrhythmia, whereas 20 patients without such arrhythmia required invasive electrophysiologic testing. The dosage of moricizine HCl was 200 mg 3 times daily, and during 5 to 6 days was titrated up to a maximum of 400 mg 3 times daily or 15 mg/kg daily, based on arrhythmia suppression and occurrence of side effects. Criteria for efficacy were a greater than 90% reduction in repetitive ventricular premature beats (couplets and runs of VT) and a greater than 50% reduction in ventricular premature beats when noninvasive methods were used. When electrophysiologic testing was used, the drug was judged effective if it prevented the induction of greater than 2 repetitive responses. Of 75 patients completing noninvasive study, 30 (40%) responded to moricizine HCl therapy, whereas only 1 of 20 patients undergoing electrophysiologic testing responded. There was no difference in moricizine HCl blood levels between responders and nonresponders (0.41 microgram/ml vs 0.43 microgram/ml, difference not significant). Side effects occurred in 28 patients (27%). Most frequent were aggravation of arrhythmia (n = 12), nausea and vomiting (n = 5), central nervous system toxicity (n = 3) and anticholinergic side effects (n = 3). The response rate to moricizine HCl therapy was higher in patients with nonsustained VT (62%) compared with those with sustained VT (19%) or ventricular fibrillation (33%).(ABSTRACT TRUNCATED AT 250 WORDS)
盐酸莫雷西嗪（乙吗噻嗪）是一种新型抗心律失常药物，应用于102例难治性室颤患者（n = 31）、持续性室性心动过速（VT）患者（n = 46）或症状性非持续性VT患者（n = 25）。82例具有高密度可重复性自发性心律失常的患者采用了利用监测和运动试验的非侵入性方法，而20例无此类心律失常的患者则需要进行侵入性电生理检查。盐酸莫雷西嗪的剂量为每日3次，每次200mg，并在5至6天内根据心律失常的抑制情况和副作用的发生情况，逐渐滴定至最大剂量每日3次，每次400mg或每日15mg/kg。疗效标准为采用非侵入性方法时，重复性室性早搏（成对室早和室速发作）减少90%以上，室性早搏减少50%以上。当采用电生理检查时，如果药物能防止诱发超过2次重复性反应，则判断为有效。在完成非侵入性研究的75例患者中，30例（40%）对盐酸莫雷西嗪治疗有反应，而在接受电生理检查的20例患者中只有1例有反应。有反应者和无反应者的盐酸莫雷西嗪血药浓度无差异（0.41μg/ml对0.43μg/ml，差异无统计学意义）。28例患者（27%）出现副作用。最常见的是心律失常加重（n = 12）、恶心和呕吐（n = 5）、中枢神经系统毒性（n = 3）和抗胆碱能副作用（n = 3）。与持续性VT患者（19%）或室颤患者（33%）相比，非持续性VT患者对盐酸莫雷西嗪治疗的反应率更高（62%）。（摘要截取自250字）
