静脉应用胺碘酮治疗老年冠心病并发快速心律失常疗效观察

Effect of amiodarone in elderly patients with coronary heart disease and tachyarrhythmia

目的探讨胺碘酮治疗老年冠心病患者合并快速心律失常的临床疗效,了解胺碘酮对血流动力学的影响。方法78例老年冠心病患者,发生快速心律失常后首剂静注负荷剂量3～5mg/kg,5～10min注入,继之以微量泵维持,如无效,15min后可再次予1～1.5mg/kg胺碘酮静注,前6h1mg/min维持,其后以0.5mg/min维持,24h总剂量900～1200mg。其中7例患者插入Swan-Ganz漂浮热稀释导管,用GEsolar9500心电监护仪及配套血流动力学插件测定和计算各项血流动力学指标。结果静脉应用胺碘酮后显效53例(67.9%),有效69例(88.4%);7例患者血流动力学监测静脉应用胺碘酮前后动脉血压、平均肺动脉压、肺毛细血管嵌压、心指数差异无统计学意义。结论胺碘酮对冠心病合并快速心律失常的老年患者血流动力学影响较小,可有效而安全的用于这些患者的抢救。

Objective To investigate the effect of amiodarone in elderly patients with coronary heart disease and tachyarrhymia. Methods 78 patients received amiodarone at a dosage of 3-5 mg/kg iv in 5-10 rain, followed by continue pumping at 1 rag/rain for the first 6 hours and 0.5mg/min there after. Seven patients inserted with Swan-Ganz floating hot dilated catheter. The pulmonary artery pressure （MPAP）, pulmonary capillary wedge pressure （PCWP） and cardiac index （CI） were record before and after amiodarone treatment. Results The efficiency rate is 88.4% in amiodarone group. The hemodynamic records indicated that pulmonary artery pressure （MPAP）, pulmonary capillary wedge pressure （PCWP） and cardiac index （CI） have no significant change. Conclusion The use of amiodarone is effective and safe on elderly patients with coronary heart disease.