静脉滴注胺碘酮治疗急性心肌梗死并心房颤动的疗效

Effect of Intravenous Amiodarone for Atrial Fibrillation in Patients with Acute Myocardlal Infarctlon

目的:观察静脉滴注胺碘酮治疗急性心肌梗死(AMI)并心房颤动(房颤)的临床疗效及安全性。方法:对27例AMI伴房颤患者静脉注射胺碘酮150 mg,继续以1 mg/min维持静脉滴注。24 h用量不超过2200 mg,观察房颤的转复及心室率的控制以及出现的不良反应。结果:27例患者用药后30 min、2 h1、2 h、24 h心室率分别为(130.2±16.8)次/min;(111.54±12.1)次/min;(98.2±10.5)次/min:(80.14±16.7)次/min,较用药前心率(148.8±18.2)次/min明显下降。房颤转复率:24 h内为72.3%(19/27),48 h内为86.2%(23/27),72 h内为92.3%(24/27)。其中3例出现心动过缓,2例出现长间歇,经停药及减量后恢复。结论:静脉滴注胺碘酮治疗AMI并发的房颤疗效明显,安全可靠。可做为首选药。

Objective： To evaluate the efficacy and safety of intravenous amiodarone for atrial fibrillation with acute myocardial infarction. Method： Twenty - seven patients with acute myocardial infarction and atrial fibrillation were with amiodarone. Amiodarone was given at 150 mg intravenous followed bv 1 mg/min in fusion. Maximum dosage was less than 2 200 mg during 24 h. Effacacy of amiodarone in the reversion of atrial fibrillation and the control of ventricular rate as well as the side effects were observed. Results： The ventricular rate 30 min, 2 hour, 12 hour, 24 hour the after the administration of amiodarone in the 27 patients was（130.2 ± 16.8） beats/min; （111.54 ±12.1）beats/min; （98.2± 10.5）beats/min; （80.14 ±16.7） beats/min, respectively, significantly lowered than the rate （148.8± 18.2 ）beats/min before the drug was given. Nineteen patients were revevted to sinus rhythm 72.3% （19/27）with in 24 hour,, 23 patients were reverted to sinus rhythm 86.2% （23/27） with in 48 hour, 24 patients were revevted to sinus rhythm 92. 396 （24/27）with in 72 hour. Sinus bradycardia occurred in 3 patients. Long intermitment Was observecd in 2 patients. Conclusion： Intravenous amiodarone is effective and safe in the treatment of fast atrial fibrillation in patients with AMI.