重叠应用胺碘酮转复心房颤动的疗效分析

Efficacy of amiodarone in treatment of atrial fibrillation

目的观察重叠应用静脉及口服胺碘酮治疗并发于器质性心脏病的心房颤动的临床疗效及安全性。方法39例心房颤动患者先给予静脉负荷量胺碘酮(150～300mg)后,继之以0.6mg/min静滴维持48小时;同时口服胺碘酮治疗,2周内给胺碘酮负荷量7g,然后维持量0.2g/d。观察临床疗效及不良反应。结果32例(82.1%)患者成功转复为窦性心律,于2小时、2～24小时、24～48小时、2～7天转复率分别为12.8%、28.2%、23.1%、18.0%。未转复组患者左房径大于转复组(P<0.05),而射血分数明显低于转复组(P<0.05),这可能是7例患者未转复的原因。2例患者用药后出现窦性心动过缓,1例出现恶心、腹胀,经减药后恢复。结论静脉及口服胺碘酮治疗并发于器质性心脏病的心房颤动是有效且较安全的方法。

Objective To observe the efficacy and security united with intravenous and oral amiodarone for atrial fibrillation (AF) with organic heart disease.Methods Thirty-nine patients of AF was treated with loaded intravenous amiodarone (150~300 mg),and then dripped one 0.6 mg/min for 48 hours,united with oral amiodarone.A loading dose of seven grams of amiodarone were given within two weeks,then the maintenance dose was 0.2 g/d.Then observe efficacy and side effects.Results 32 patients reversed to sinus rhythm,the reverse rate was 12.8%、28.2%、23.1%、18.0% at 2h、2~24h、24~48h、2~7d respectively.Sinus bradycardia was observed in 2 patients,nausea、bloated feeling in 1 patient,which disappeared after reduce.Conclusion The results showed it was effective and safe united intravenous and oral amiodarone in treatment of atrial fibrillation with organic heart disease.