静脉应用胺碘酮治疗冠心病合并心房颤动伴快速心室反应和频发室性早搏  

Intravenous amiodarone for the treatment of atrial fibrillation with rapid ventricular response or frequent premature ventricular contraction in patients with coronary artery disease

作　　者：李亚萍[1] 郭丽军[2] 

机构地区：[1]清华大学医院内科,北京100084 [2]北京大学第三医院心内科

出　　处：《中华心律失常学杂志》2007年第3期204-205,共2页Chinese Journal of Cardiac Arrhythmias

摘　　要：目的：评价经静脉应用胺碘酮治疗合并心房颤动伴快速心室反应和频发室性早搏的冠心病患者的临床疗效和安全性。方法：232例符合人选条件的冠心病患者，首剂静脉注射150mg胺碘酮负荷量，10min注入。随后以1．0mg／min静脉滴注维持6h，以后根据病情逐渐减量至0．5mg／min。对于心室率控制不满意者，间隔15～30min后，再次给予胺碘酮150mg的追加负荷量2～3次，24h总剂量在2000mg以内。用药期间，持续性心电图、血压及血氧饱和度监测，并判定疗效及副反应。心室率降至100次／min以下，或较用药前下降〉20％，或心律转复为窦性心律为有效；心室率仍〉100次／min或较用药前下降〈20％为无效。结果：232例患者总有效率为90．5％，副反应发生率为4．3％。结论：经静脉应用胺碘酮治疗合并心房颤动伴快速心室反应和频发室性早搏的冠心病患者是安全、有效的。Objective To evaluate the efficiency and safety of intravenous amiodarone for the treatment of atrial fibrillation with rapid ventricular response or frequnt premature ventrlcular contraction （PVC） ,in patients with coronary artery disease. Methods A total of 232 patients with atrial fibrillation with rapid ventricular response or frequent PVC and coronary artery disease were involved in the present study. The first bolus of 150 mg amiodarone was given in 10 minutes, then 1.0 mg/min in 6 hours by intravenous, and then 0. 5 mg/ min according to the state of patients. If the ventricular rate was still out of control, an additional bolus of 150 mg would be given 15 ～30 min later or repeated 2 ～3 times if necessarily. The total dosage was less than 2000 mg within 24 hours. Blood pressure and electrocardiolography were monitored during the medication procedure. It was considered as effective if ventricular rate lowered to be less than 100 bpm or decreased by more than 20% of the baseline or conversion to sinus rhythm. Results The total effective rate was 90.5% and side-effect rate was 4. 3%. Conclusion It is effective and safe of intravenous medication of amiodarone for the treatment of atrial fibrillation with rapid ventricular response or frequent PVC, in patients with coronary artery disease .

关 键 词：胺碘酮 冠心病 心房颤动 室性早搏 

分 类 号：R541[医药卫生—心血管疾病]