胺碘酮在急性心肌梗死后室性心律失常治疗中的应用价值

Application value of amiodarone in the treatment of ventricular arrhythmia after acute myocardial infarction

目的 :探讨胺碘酮在急性心肌梗死后室性心律失常治疗中的应用价值。方法 :选择2019年1月至2020年7月收治的急性心肌梗死后室性心律失常患者100例,按照随机数字对照法分为两组各50例。对照组静脉推注利多卡因50 mg,之后按2.2 mg/min静脉滴注维持治疗8 h,共2周。观察组每天静脉推注胺碘酮150 mg,之后按1.5 mg/min静脉滴注维持治疗8 h,共2周。比较两组治疗效果和安全性。结果 :观察组治疗总有效率为94.00%(47/50),高于对照组的80.00%(40/50,P <0.05)。治疗后,观察组复律时间为(13.11±2.77)min,短于对照组的(15.98±3.18)min(P <0.05)。治疗后,观察组收缩压(SBP)、舒张压(DBP)、左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)检测结果均低于对照组,左心室射血分数(LVEF)均高于对照组(P <0.05)。两组治疗前后QT间期及PR间期时间均未发生明显改变。观察组药物相关不良反应总发生率为8.00%(4/50)低于对照组的28.00%(14/50,P <0.05)。结论 :胺碘酮治疗急性心肌梗死后室性心律失常效果优于利多卡因,能够有效改善患者的心功能,且不良反应少,值得临床推荐。

Objective:To investigate the application value of amiodarone in the treatment of ventricular arrhythmia after acute myocardial infarction.Methods:One hundred patients with ventricular arrhythmia after acute myocardial infarction were selected from January 2019 to July 2020,and according to the random number control method divided into two groups with 50 cases in each group.In the control group,lidocaine 50 mg was injected intravenously,followed by intravenous infusion of 2.2 mg/min for maintenance treatment for 8 hours for 2 weeks.In the observation group,150 mg of amiodarone was injected intravenously every day,followed by intravenous drip at 1.5 mg/min for 8 h for 2 weeks.The therapeutic effect and safety of the two groups were compared.Results:The total effective rate of treatment in the observation group was 94.00%(47/50),which was higher than that in the control group 80.00%(40/50,P<0.05).After treatment,the cardioversion time in the observation group was(13.11±2.77)min,which was shorter than that in the control group(15.98±3.18)min(P<0.05).After treatment,the systolic blood pressure(SBP),diastolic blood pressure(DBP),left ventricular end diastolic volume(LVEDV)and left ventricular end systolic volume(LVESV)test results in the observation group were lower than those in the control group,and the left ventricular ejection fraction(LVEF)was higher than that in the control group(P<0.05).There was no significant change in QT interval and PR interval between the two groups before and after treatment.The total incidence of drug-related adverse reactions in the observation group was 8.00%(4/50),which was lower than that in the control group 28.00%(14/50,P<0.05).Conclusion:Amiodarone is better than lidocaine in the treatment of ventricular arrhythmia after acute myocardial infarction,and can effectively improve the cardiac function of patients with less adverse reactions,which is worthy of clinical recommendation.