Leclercq J F, Attuel P, Milosevic D, Rosengarten M D, Coumel P
Arch Mal Coeur Vaiss. 1981 Aug;74(8):923-30.
The object of this study was to compare the efficacity and the side effects of Aprindine and Quinidine in patients with stable ventricular arrhythmias. A series of 33 patients with chronic stable ventricular arrhythmias were given successively Aprindine and Quinidine on the principle of extrasystoles (VES) determined by computer analysis of Holter recordings. The VES were counted every hour and the statistical study used analysis of variance followed by linear contrast and also the sign test. The stability of the arrhythmia was verified by several control Holter recordings without therapy (average : 3,3 per patient). Low dose regimes were used in 17 patients (an average of 50 to 60mg/day Aprindine, and 481 mg Quinidine base), and Quinidine was shown to be the more active (p less than 0.05 to 0.003 according to the test used), reducing the number of VES by 39% compared to an average of 21% for Aprindine. In the other 16 patients with a higher dosage regime, 109 mg Aprindine and 707 mg Quinidine base, there was no significant difference between Quinidine and Aprindine (p less than 0.08 to 0.12), Quinidine reducing the number of VES by an average of 54%, and Aprindine by 36%. Quinidine caused diarrhoea in I patient on the low dose and 4 patients in the high dose regime. Aprindine caused neurological side effects in 2 patients on the low dose, and 7 patients on the high dose regime. Aprindine at 100 mg/day may therefore be used in the same manner as Quinidine at usual dosages as regards the incidence of side effects of the two drugs. However, the ratio of effective dose/toxic dose is lower with Aprindine than with Quinidine.
本研究的目的是比较阿普林定和奎尼丁对稳定性室性心律失常患者的疗效及副作用。对33例慢性稳定性室性心律失常患者,根据动态心电图记录经计算机分析确定的早搏(室性早搏)情况,先后给予阿普林定和奎尼丁。每小时统计室性早搏数量,统计研究采用方差分析,随后进行线性对比以及符号检验。通过多次未治疗的动态心电图记录(平均每位患者3.3次)验证心律失常的稳定性。17例患者采用低剂量方案(阿普林定平均每日50至60毫克,奎尼丁碱481毫克),结果显示奎尼丁活性更强(根据所用检验,p值小于0.05至0.003),与阿普林定平均降低21%相比,奎尼丁使室性早搏数量减少39%。在另外16例采用高剂量方案(阿普林定109毫克,奎尼丁碱707毫克)的患者中,奎尼丁和阿普林定之间无显著差异(p值小于0.08至0.12),奎尼丁使室性早搏数量平均减少54%,阿普林定减少36%。低剂量时,奎尼丁使1例患者出现腹泻;高剂量时,使4例患者出现腹泻。低剂量时,阿普林定使2例患者出现神经方面的副作用;高剂量时,使7例患者出现神经方面的副作用。因此,就两种药物副作用的发生率而言,阿普林定每日100毫克的用法可与奎尼丁常用剂量的用法相同。然而,阿普林定的有效剂量/毒性剂量比低于奎尼丁。