静脉应用胺碘酮治疗围产期心肌病合并快速心房颤动和室性心律失常  

Clinical observation on intravenous amiodarone in the treatment of peripartal cardiomyopathy complicated with fast atrial fibrillation and ventricular arrhythmia

作　　者：王晓娜[1] 贾新未[2] 张晶[3] 陈春红[2] 王占启[2] 陈艳霞[2] 

机构地区：[1]河北省保定市妇幼保健院,071000 [2]河北大学附属医院 [3]河北医科大学第二医院

出　　处：《河北医药》2009年第10期1175-1176,共2页Hebei Medical Journal

摘　　要：目的探讨对围产期心肌病合并快速心房颤动以及室性心律失常患者使用静脉胺碘酮的安全性和有效性。方法选择围产期心肌病合并快速心房颤动以及室性心律失常患者82例,在入院后行常规治疗的基础上静脉应用胺碘酮治疗,观察治疗前后患者心功能变化、转复窦性心律发生率、治疗前后2h内心室率变化、室性早博数目、短阵室性心动过速次数,药物不良反应等。结果应用胺碘酮静脉推注后快速心房颤动转复窦性心律39例(84.7%)。静脉给予胺碘酮后,患者心功能显著恢复(P<0.05);心室率显著降低,室性早博及室性心动过速数目显著减少(P<0.01),而收缩压和舒张压虽然有下降的趋势,但差异无统计学意义(P>0.05)。发生不良反应4例(4.89%)。其中血压降低3例,窦性心动过缓1例,未见心力衰竭加重、急性左心衰竭及尖端扭转室性心动过速发生。结论对围产期心肌病患者合并快速心室率或频发室性心律失常时静脉应用胺碘酮安全、有效。Objective To investigate the safety and efficacy of intravenous amiodarone treatment for peripartal cardiomyopathy complicated with fast atrial fibrillation and ventricle arrhythmia. Methods 82 patients with peripartal cardiomyopathy complicated with fast atrial fibrillation and ventricle arrhythmia were given intravenous amiodarone, and the changes of cardiac function and ventricular rate, the number of arrhythmia and side effects were observed. Results Intravenous amiodarone could reverse atrial fibrillation to sinus rhythm in 39 patients（ 84.7% ）. After intravenous amiodarone treatment the patients ＂ cardiac function improved obviously, ventricular rate was decreased significantly, the number of ventricular premature pulse and ventricular tachycardia was reduced remarkably. Although there was a trend of decrease of systolic blood pressure and diastolic blood pressure,there was no statistical significance（ P 〉0.05）. The side effects were found in 4 patients （4.89%）, including low blood pressure in 3 patients and sinus bradycardia in 1 patient. No severe heart failure, acute left heart failure and torsades de points （Tdp） were found. Conclusion Intravenous amiodarone treatment for peripartal cardiomyopathy complicated with fast atrial fibrillation and ventricle arrhythmia is safe and effective, but electrocardiographic and blood pressure monitoring is necessary.

关 键 词：围产期心肌病 心房颤动 室性心律失常 静脉 胺碘酮 

分 类 号：R714.252[医药卫生—妇产科学] R541.7[医药卫生—临床医学]