普罗帕酮联合胺碘酮治疗老年急性心肌梗死合并AF的临床分析

Treatment of elderly patients with AMI and AF by Propafenone and Amiodarone and analysis the efficacy and adverse reactions

目的探讨普罗帕酮联合胺碘酮治疗老年急性心肌梗死（AMI）合并心房颤动（AF）的疗效及不良反应。方法选取2008年1月-2014年3月收治的AMI合并有AF的老年患者96例,随机分成对照组和试验组,每组48例。对照组患者应用胺碘酮治疗,试验组患者采用普罗帕酮联合胺碘酮治疗。分析比较两组患者接受治疗后心房颤动转复效果、窦性心律维持率及不良反应情况。结果 0-6 h及6-12 h内试验组患者AF转复率高于对照组（χ^2=6.400、8.491,P〈0.05）,18-24 h内对照组高于试验组（χ^2=5.897,P〈0.05）,12-18 h内和总转复率差异无统计学意义（χ^2=2.987、1.200,P〉0.05）。试验组窦性心律维持有效率明显高于对照组,差异具有统计学意义（χ^2=20.364,P〈0.05）。试验组不良反应率低于对照组（χ^2=7.940,P〈0.05）。结论普罗帕酮联合胺碘酮治疗AMI并发AF效果和安全性优于单独给予胺碘酮。

Objective To explore the treatment of elderly patients with acute myocardial infection（AMI）and atrial fibrillation（AF）by propafenone and amiodarone and analysis it efficacy and adverse reactions. Methods Ninety six elderly patients with AMI merger with AF in our hospital from January 2008 to March 2014 were collected and randomly divided into control and experimental groups,each group of 48. The control group were treated with amiodarone and the experimental group were treated with propafenone and amiodarone. Cardioversion of atrial fibrillation,sinus rhythm maintenance rate and adverse reactions of the two groups were analyzed and compared after treatment. Results The AF cardioversion rate of experimental group was significantly higher than that of control group in 0-6 h and 6-12 h（χ^2=6.400、8.491,P〈0.05）,control group was significantly higher than the treatment group in 18-24 h（χ^2=5.897,P〈0.05）,There were no statistical differences in the cardioversion rate of 12-18 h and total（χ^2=2.987、1.200,P〉0.05）. Sinus rhythm maintenance rate of experimental group was significantly higher than control group（χ^2 = 20.364,P〈 0.05）. Adverse reaction rates of the experimental group was significantly lower than the control group（χ^2=7.940,P〈0.05）. Conclusion Treatment of AMI and AF by propafenone and amiodarone are more superior and safety than amiodarone alone,is worth in on promoting the application clinically.