胺碘酮治疗老年人心律失常几种用药方案的观察分析

ANALYSIS OF DIFFERENT THERAPEUTIC SCHEMES OF AMIO DARONE FOR TREATMENT OF ARRHYTHMIA IN THE ELDERLY

目的 本文对胺磺酮治疗 60岁以上老年人心律失常剂量、血药浓度与疗效、不良反应进行观察分析。 方法 64例患者分三组。 A组 39例： 0.2tid× 7d± 3d后 0.2bid× 7d± 3d后 0.2qd维持； B组 11例： 0.2bid× 7d± 3d后 0.2qd维持； C组 14例： 0.2qd。各组分别于起始负荷剂量减量时测血药浓度，清晨服药前测谷浓度，服药后 5.5h测定峰浓度。 结果 A、 B、 C三组平均谷浓度分别为 612.2± 400.0、 520.8± 426.2、 3030.8± 216.6(ng/ml)；平均峰浓度分别为 968.0± 897.3、 933.3± 478.2、 804.7± 361.6(ng/ml)。三组谷浓度和峰浓度均无显著性差异，剂量与浓度无显著相关性。起效时间 (天 )分别为 8.111± 5.766、 6.900± 4.748、 17.20± 12.28。 A、 C组和 B、 C组均有显著性差异。 64例患者中 13例发生不良反应，不良反应发生率 20.31％。 结论 低负荷量和维持量的胺碘酮治疗老年人心律失常是安全有效的。

Objective This paper sought to analyse the dosage、 concentration in plasma、 effect and side－ effects of Amiodarone for treatment of arrhythmia in the elderly( >60y). Methods 64 patients over 60 years of age with various types of arrhythmia were divided into 3 groups. Group A consisted of 39 patients receiving Amiodarone 0.2 tid for (7± 3) days followed by 0.2 bid for another (7± 3) days and then a maintenance dose of 0.2 qd.Group B consisted of 11 patients receiving Amiodarone 0.2 bid for(7± 3) days and then a maintenance dose of 0.2 qd. Group C consisted of 14 patients receiving Amiodarone 0.2 qd. The concentration of Amiodarone was determined after the administration of the initial loading dose and after the dose was cut down. The valley concentration was determined before the administration of Amiodarone in early morning and the peak concentration was determined 5.5 hours after administration. Results The valley concentration of 3 groups was 612.2± 400.0、 520.8± 426.2 and 303.8± 216.6(ng/ml) respectively. The peak concentration of 3 groups was 968.0± 897.3、 933.3± 478.2 and 804.7± 361.6 (ng/ml) respectively. There was no significant difference between 3 groups in both valley and peak concentrations, and there was also no significant correlation between the dosage and the concentration in serum. The acting time of Amiodarone was 8.111± 5.766、 6.900± 4.748 and 17.20± 12.28 (day) respectively. The difference in acting time was significant between group A and C as well as group B and C. The total effective rate of 3 groups were 87.18％、 72.73％ and 78.57％、 respectively. There was no significant difference in antiarrhythmic effect in 3 groups. Of the 64 patients, 13 (20.31％ )developed side－ effects. Conclusions It's safe and effective in antiarrhythmic therapy for elder patient by using low loading and maintenance dose of Amiodarone.