胺碘酮治疗老年急性心肌梗死伴心房颤动的临床研究

Clinical Study of Amiodarone in the Treatment of Elderly Patients with Acute Myocardial Infarction Complicated with Atrial Fibrillation

目的:探究胺碘酮治疗老年急性心肌梗死(AMI)伴心房颤动的疗程疗效。方法:选取于2014年1月-2016年6月来我院诊治的AMI且合并心房颤动患者74例为研究对象,采用随机数字表法分为观察组和对照组,每组各37例;观察组采用胺碘酮治疗,对照组采用毛花苷丙治疗,评价两组治疗效果,比较两组房颤动控制率、窦性心律维持率、病死率及不良反应发生率。结果:观察组的显效率、总有效率分别为73.0%(18/37)、94.6%(27/37),明显高于对照组的48.6%(27/37)、73.0%(35/37),差异有统计学意义(P=0.032,P=0.021);房颤动控制率及窦性心律维持率分别为67.6%(25/37)、81.1%(30/37)明显高于对照组的43.2%(16/37)、45.9%(17/37),差异有统计学意义(P=0.035,P=0.002);病死率及不良反应发生率分别为5.4%(2/37)、10.8%(4/37)明显低于对照组的21.6%(8/37)、51.8%(19/37),差异有统计学意义(P=0.041,P<0.001)。结论:胺碘酮治疗老年AMI伴心房颤动的临床疗效显著,药物不良反应的发生率较低,安全有效,值得在临床应用推广。

Objective： To explore the efficacy of amiodarone in the treatment of elderly patients with acute myocardial infarction combined atrial fibrillation. Methods： 74 cases were selected from January 2014 to 2016 in our hospital for treatment of acute myocardial infarction with atrial fibrillation. All cases were divided into observation group and control group,with 37 cases of patients in each group;The patients in the observation group were treated with amiodarone,and the control group with Lanatoside C for the treatment.The atrial fibrillation cardioversion, the maintenance of sinus rhythm, mortality rate and adverse reaction incidence were observed between the two group. Results： The significant efficiency and total effective rate of the observation group were 73%（18/37） and 94.6%（27/37）, significantly higher than that in the control group of 48.6%（27/37）,73%（35/37）, the difference was statistically significant（P=0.032, P=0.021）;Atrial fibrillation control rate and sinus rhythm maintenance rate were 67.6%（25/37） and 81.1%（30/37）, significantly higher than that in the control group of 43.2%（16/37）, 45.9%（17/37）, the difference was statistically significant（P=0.035, P=0.002）; The mortality and incidence of adverse reactions were 5.4%（2/37） and 10.8%（4/37）, significantly lower than the control group of 21.6%（8/37）,51.8%（19/37）,the difference was statistically significant（P=0.041, P〈0.001）. Conclusion： Amiodarone in the treatment of elderly acute myocardial infarction combined atrial fibrillation patients is observed to be safe, effective and worthy of clinical application and promotion.