静脉滴注胺碘酮治疗急性心肌梗死伴发房颤的临床疗效

Clinical efficacy of intravenous infusion of amiodarone for primary atrial fibrillation acute myocardial infarction

目的探讨静脉滴注胺碘酮治疗急性心肌梗死并新发房颤的临床疗效及其安全性。方法 60例急性心肌梗死伴新发快速房颤,静脉应用胺碘酮,先静脉推注负荷量后,继以静脉滴注维持,观察房颤转复、心室率控制、血压及Q-T间期变化情况及药物不良反应。结果 60例患者用药后0.25、1、2、24 h的心室率分别是(136.2±19.4)、(119.4±15.9)、(101.5±14.1)、(82.7±20.8)次·min^(-1),较用药前心室率(140.3±17.5)次·min^(-1)明显下降(P<0.01);44例(占73.3%)转复窦性心律;血压、Q-T间期在用药前后差异无统计学意义(P>0.05)。本组患者中1例出现窦性心动过缓;1例出现长R-R间期,经停药后恢复正常;1例用药期间发生静脉炎。结论静脉滴注胺碘酮治疗急性心肌梗死并新发快速房颤是安全及有效的。

A/M To determine the clinical efficacy of intravenous amiodarone for primary atrial fibrillation complicating acute myocardial infarction. METHODS Acute myocardial infarction patients （ n = 60） with recent onset of fast atrial fibrillation were studied. After an initial intravenous infusion of amiodarone load, a continuous amiodarone infusion followed. The turning over of heart rhythm, the rate of ventricle, arterial blood pressure, Q-T interval and adverse drug reactions were observed. RESULTS After administration of amiodarone, the ventricular rates at 15 min, 1 h, 2 h and 24 h were： （ 136.2 ± 19.4）, （ 119.4 ± 15.9）, （ 101.5 ± 14.1 ） and （ 82.7 ± 20.8） beats·min-1, respectively. The rates were significantly lower than the （140.3 ± 17.5）beats-min-1 before the medication was given （P 〈 0.01）. Atrial fibrillation reverted to sinus rhythm in 44 patients （73.3 %） ; the arterial blood pressure and Q-T interval after amiodarone infusion remained the same （P 〉 0.05）. One patient suffered sinus bradycardia. One patient experienced long R-R interval but returned to normal after stopping the infusion. Phlebitis occurred in one patient. No other adverse drug reactions were observed. CONCLUSION Intravenous infusion of amiodarone is effective and safe in the treatment of fast atrial fibrillation patients with acute myocardial infarction.