胺碘酮对心室复极波形态影响的临床意义

The clinical significance of using amiodarone on the change of the ventricular repolarization wave shape

目的 探讨胺碘酮对心室复极波形态的影响。 方法 选择各类心律失常 194例按下列剂量与方法口服胺碘酮 40 0～ 6 0 0 mg/日 ,10天后改服 2 0 0～ 40 0 m g/日 ,并重点观察 ST- TU、H.R、Q- T间期等变化情况。 结果 显效 144例 (74.2 3% ) ,有效 36例 (18.3% ) ,总有效率 92 .5 9%。窦性心动过缓 30例 (15 .46 % ) ,P- R间期延长者 10例 (5 .15 % ) ,连结区逸搏节律 6例 (3.0 % ) ,Q- T间期延长者 16例 (8.2 5 % )。 148例 ST- T形态正常者 ,在应用胺碘酮治疗和维持治疗期间 ,出现 12 2例 (82 .43% )心室复极波形态变化。其中 ST段水平下移者 4例 (2 .70 % ) ,T波峰值消失 40例 (2 7.0 % ) ,平直 18例(12 .16 % ) ,双峰、双相 44例 (2 9.73% ) ,倒置者 8例 (5 .41% ) ,U波增大及倒置各 4例 (5 .41% )。 结论 胺碘酮导致 ST- TU形态的改变 。

Objective To investigate the change of the ventricular repolarization wave shape(VRWS) after using amiodarone for the patients with arrhythmia. Methods At the first ten days amiodarone 400～600mg/day was taken then changed to 200～400mg/day for 194 patients with arrhythmia,and at same time observed the change of VRWS. Results After treatment it got a good curative effect.144 cases were obviously effective(74.23%),and others 36 cases were effective(18.3%),the total effective rate was 92.59%.In all patients there were 30 cases of sinus bradycardia(15.46%),10 cases of prolongation of P R interval(5.15%),6 cases of escape beat rhythm(3.0%),and 16 cases of prolongation of Q T interval(8.25%).Before treatment the VRWS was normal in 148 cases,but after treatment they were found that their VRWS had different changes:the ST T segment,was depression in 4 cases(27.00%),negative T wave in 40 cases(27.0%) flat in 18 cases(12.16%),double peak and diphasic T wave in 44 cases(29.73%),U wave was large or inverted each in 4 cases(2.70%). Conclusion It might cause the shape of ST-TU to be changed after the treatment by using amiodarone in the patients with arrhythmia,this could be the amiodarone influnced the ventricular vepolarization and made it became postponent and nonproportionate.