不同剂量胺碘酮治疗心律失常老年患者的疗效分析

Efficacy analysis of various doses of amiodarone in treatment of cardiac arrhythmia in elderly patients

目的观察不同剂量胺碘酮治疗心律失常老年患者的疗效。方法 120例老年心律失常患者随机分为A、B、C三组,分别采用高、中、低剂量的胺碘酮口服治疗,观察两组患者治疗前后心悸、胸闷等症状和动态心电图的变化,并监测三组患者用药后的血药浓度峰值。结果三组患者总有效率分别为82.5%、80.0%、80.0%,三组患者疗效对比差异无统计学意义(P>0.05);用药后A组患者的血药浓度峰值明显高于B组和C组,且B组高于C组,差异均具有统计学意义(P<0.05);A组和B组起效时间明显短于C组,差异具有统计学意义(P<0.05),但A组和B组差异无统计学意义(P>0.05)。结论口服胺碘酮要根据临床实际疗效,调整负荷量和维持量,以最小的维持量求得最好的疗效。

Objective To evaluate the clinical efficacy of various doses of amiodarone in the treatment of cardiac arrhythmia in elderly patients. Methods A total of 120 elderly patients with cardiac arrhythmia were randomly allocated to groups A, B, and C, and treated with high, medium, and low doses of oral amiodarone, respectively. The symptoms such as palpitation and chest distress were recorded, and the changes in dynamic electrocardiogram were measured in all groups before and after treatment. The maximum plasma concentration after medication was monitored in all groups. Results The overall response rates in the three groups were 82.5%, 80.0%, and 80.0%, respectively, and showed no significant difference between groups（P〉0.05）. After treatment, the maximum plasma concentration in group A was significantly higher than that in groups B and C; meanwhile, group B showed a significantly higher concentration than group C（all P〈0.05）. Groups A and B had a significantly faster onset of action than group C（P〈0.05）, but no significant difference was observed between groups A and B（P〉0.05）. Conclusion The loading dose and maintaining dose of oral amiodarone should be adjusted following the therapeutic effect in order to achieve the best treatment outcome with a minimal maintaining dose.