胺碘酮治疗急性心肌梗死合并心房颤动的临床探讨

Clinical Observation of Amiodarone in Treatment of Acute Myocardial Infarction Complicated With Atrial Fibrillation

目的探析胺碘酮治疗急性心肌梗死合并心房颤动的临床治疗效果及安全性,旨在为今后临床更有效地治疗该疾病提供重要的参考和借鉴依据。方法前瞻性随机选取该院心内科于2013年1月—2014年12月期间收治的120例确诊为急性心肌梗死合并心房颤动患者,采用随机抽签法将其分为2组,对照组给予常规普罗帕酮治疗,治疗组给予胺碘酮治疗,对比分析两组患者治疗效果及不良反应发生情况。结果经治疗6、6~12、12~18、18~24 h,治疗组心房颤动转复率均明显高于对照组(P<0.05),总转复率为91.67%明显高于对照组的70.00%(χ2=9.09.01,P=0.0026);治疗组心房颤动转复后30d内窦性心律维持显效率和总有效率分别为30.00%、78.33%明显高于对照组的10.00%、41.67%(χ2=7.5000,P=0.0062;χ2=16.8056,P=0.0000);治疗组患者不良发生率10.00%明显低于对照组的31.67%(χ2=8.5389;P=0.0035)。结论胺碘酮治疗心律失常合并心房颤动疗效显著,安全性高,可作为临床首选治疗方案之一。

Objective Analysis of amiodarone in treatment of acute myocardial infarction clinical curative effect and safety of combined with atrial fibrillation, which aims to provide an important reference for future clinical and more effective in treating the disease reference. Methods 120 cases diagnosed prospectively selected from Department of Cardiology in our hospital during2013 January to December^2014 for acute myocardial infarction with atrial fibrillation patientswith randomly divided into 2 groups, the control group was given conventional propafenone treatment, the treatment group received the treatment of amiodarone, comparative analysis and the incidence of adverse reactions in patients with therapeutic effect the two group. Results After treatment, 6h, 6~12h, 12~18h, 18~24h, atrial cardioversion rate of the treatment group were significantly higher than those in control group （P〈0.05） fibrillation cardioversionrate was 91.67%, the total was higher than that of the control group of 70% （χ2=9.09.01,P=0.0026）;the treatment group atrial cardioversion within 30d after the maintenance of sinus rhythm significant effective rate and total the ef-fective rate were 30%and 78.33%higher than the control group obviously 10%, 41.67%AF （χ2=7.5000,P=0.0062;χ2=16.8056,P=0.0000）; the rate of malnutrition was 10% patients in the treatment group were significantly lower than the control group 31.67%（χ2=8.5389;P=0.0035）. Conclusion Amiodarone in the treatment of arrhythmia in patients with atrial fibrillation and remarkable curative effect, high safety, can be used as one of the preferred clinical treatment.