胺碘酮治疗急性冠脉综合征伴心力衰竭的室性心律失常疗效观察(1)
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2011年4月15日
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[摘要] 目的：观察胺碘酮对急性冠脉综合征(ACS)伴心力衰竭患者室性心律失常的疗效和安全性。方法：对52例ACS伴心力衰竭并发室性心律失常的患者，首剂给予胺碘酮3～5 mg/kg静注，10～20 min注完，之后给予0.75～1.50 mg/min静滴维持。若心律失常控制不满意,可间隔30 min重复注射胺碘酮150 mg一次，同时口服胺碘酮0.2 mg，tid，治疗5 d。结果：52例患者中，显效35例(67.3%)，有效11例(21.2%)，无效6例(11.5%)，总有效率为88.5%，静脉应用早期对P-R、QRS、QT间期均无影响。结论：胺碘酮对ACS伴心力衰竭的室性心律失常有良好的疗效。
[关键词] 急性冠脉综合征；心力衰竭；室性心律失常；胺碘酮
[中图分类号] R541 [文献标识码]B[文章编号]1673-7210(2011)04(b)-062-02
Observation of curative effects of Amiodarone on patients with acute coronary syndrome (ACS) and chronic heart failure and ventricular arrythmia
ZOU Peiyuan, FENG Xiaoyan
Department of Cardiology, the Hospital of Chinese Medicine of Yangjiang City, Yangjiang 529500, China
[Abstract] Objective: To observe the efficacy and safety of Amiodarone in treatment of ventricular arrythmia on acute coronary syndrome (ACS) and chronic heart failure patients and ventricular arrythmia. Methods: On the basis of regular treatment, Amiodarone was used in 52 patients with ACS and chronic heart failure and ventricular arrythmia, intravenous loading does of 3-5 mg/kg of Amiodarone was given within 10-20 min, followed by 0.75-1.50. mg/min infusion. If ventricular arrythmia was uncontrolled, additional bolus of 150 mg could be repeated every other 30 min, and oral Amiodarone 0.2 mg, tid, observation treatment for five days. Results: In 52 patients, 35 cases (67.3%) were significant effective, 11 cases (21.2%) were effective, 6 cases (11.5%) were invalid, the total effective rate was 88.5%. There were no significant changes in the P-R, QRS, QT intervals during iv Amiodarone therapy. Conclusion: Amiodarone can be used effectively and safely to control ventricular arrythmia on ACS with chronic heart failure patients.
[Key words] Acute coronary syndrome; Heart failure; Ventricular arrythmia; Amiodarone
ACS是临床危重病，常并发心律失常，其中频发性室性早搏易诱发室速VT和室颤VF，而VT和VF常伴有严重的血流动力学障碍，加重心力衰竭，甚至猝死[1]。胺碘酮是一种临床常用的抗心律失常药物，同时具有扩血管和抗心肌缺血作用，可使心力衰竭症状得以改善，其抗心律失常作用疗效确切，尤其对室性心律失常有较好的疗效。笔者对我院2008年1月～2010年3月共收治的52例ACS伴心力衰竭并发室性心律失常患者应用静脉胺碘酮治疗，对其疗效性和安全性进行分析如下： ......
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