胺碘酮与利多卡因治疗心肌梗死并发室性心律失常的疗效及安全性评价

System evaluation of effect and safety of Amiodarone and Lidocaine on myocardial infarction complicated with ventricular arrhythmia

目的评价胺碘酮与利多卡因治疗急性心肌梗死（AMI）并室性心律失常的疗效及安全性。方法120例AMI患者完全随机分为胺碘酮组和利多卡因组各60例。所有患者均按AMI常规处理，胺碘酮组予胺碘酮[首剂150mg＋生理盐水20ml，10min内注入，再以（1～1．5）mg／min静脉滴注6h，再减量至0．5mg／min，同时予本药口服]治疗；利多卡因组予利多卡因（1～1．5）mg／min静脉推注，随后以（1～4）mg／min静脉滴注。观察2组疗效及不良反应。结果胺碘酮组总有效53例（88．33％），病死率6．67％（4例）；利多卡因组有效34例（56．67％），病死率13．33％（8例），2组差异有统计学意义。胺碘酮组发生药物不良反应16例，利多卡因组发生27例，差异有统计学意义（P〈0．05）。结论胺碘酮治疗AMI并室性心律失常疗效显著，能明显降低AMI并室性心律失常患者不良反应发生率及病死率，推荐作为治疗AMI并室性心律失常药物治疗的首选药物。

Objective To evaluate the curative effect and security of Amiodarone and Lidocaine in the treatment of myocardial infarction complicated with ventricular arrhythmia following acute myocardial infarction. Methods One hundred and twenty cases were randomly divided into two group s as Amiodarone group with 60 cases and Lidocaine group with 60 cases. And the retrospective comparison and analysis of curative effect, mortality and adverse drug reactions of the two kinds of medication on treatment of myocardial infarction complicated with ven- tricular arrhythmia following acute myocardial infarction. Results The rate curative effect, the incidence of adverse drug reactions and mortality of amiodarone group were 88.33%, 6. 67%, 26.7%. Lidocaine group： 55.66%, 13.33% ,45%. There is significant difference between lidocaine group and amiodarone group （P 〈 0. 05 ）. Conclusions The therapeutic effectiveness of amiodarone in the treatment of acute myocardial infarction complicated with ventrieular arrhythmia is significant. Amiodarone can obviously reduce the incidence of adverse drug reactions and mortality on the acute myocardial infarction patients complicated with ventrieular arrhythmia, and is recommended as the first choice for treating AMI complicated with ventricular arrhythmia.