扩张型心肌病室速和室颤的抢救治疗及随访

Treatment and follow-up of ditated cardiomyopathy with ventricular tachycardia and ventricular fibrillation

目的 探讨应用胺碘酮 (AM)对扩张型心肌病 (DCM)伴室性心动过速 (VT)和 (或 )心室颤动 (VF)的治疗及预防疗效。方法 本组 19例 DCM伴 VT和 (或 ) VF,左室射血分数 (L VEF) (2 3± 8.2 ) % ,静脉注射 AM首剂 3～ 5 mg/kg,稀释后 10～ 2 0分钟注入 ,继以 0 .75～ 1mg/min维持静脉注射 ,如心律失常控制不满意 ,可每隔 30分钟追加 75～ 15 0 mg的 AM。在静脉用药的同时口服 AM6 0 0～ 80 0 mg/d。结果 11/19患者 2 4小时心律失常获控制占 5 8% ,AM静脉用量平均为 (12 41± 12 5 .5 ) mg(115 6～ 2 14 2 mg) ,72小时完全控制心律失常。结论 静脉注射 AM治疗 DCM并 VT和 (或 ) VF安全有效 ,预防心律失常发作需长期口服 AM。

Objective To evaluate the efficacy of amiodarone (AM) in the treatment and prevention of ditated cardiomyopathy (DCM) with ventricular tachycardia (VT) or ventricular fibrillation (VF).Methods 19 patients with sustained VT and (or) VF and LVEF (23±8.2)% were enrolled in the study.Intravenous loading dose of 3～5 mg/kg of AM was given,which was followed by 0.75～1 mg/min infusion.If VT and (or) VF was uncontrolled,additional bolus of 75～150 mg could be repeated.Oral AM of 600～800 mg daily was required simultaneously.ResultsThe mean dose was (1 241±125.5)mg at the first day with disappearance of arrhythmia 58% and after 3 days,total control of arrhythmia was resulted in.Conclusion Intravenous AM has a high efficacy for the treatment of VT and (or) VF.Long term oral of AM is effective for the prevention of arrhythmic deaths.