胺碘酮治疗老年心力衰竭合并快速心律失常的疗效和安全性  

Effect of amiodarone on rapid cardiac arrhythmias in the elderly patients with chronic heart failure

作　　者：杨淑芳[1] 秦俭[1] 王晶[1] 

机构地区：[1]首都医科大学附属宣武医院急诊科,北京100053

出　　处：《中国急救复苏与灾害医学杂志》2009年第3期151-152,共2页China Journal of Emergency Resuscitation and Disaster Medicine

摘　　要：目的观察胺碘酮治疗老年慢性心力衰竭合并快速心律失常的疗效和安全性。方法124例快速心律失常患者，年龄（79±6．3）（70-93）岁，首剂静注胺碘酮150mg，10min注入，随后1mg/min维持静滴6h，0．5mg/min维持静滴至24～48h。首剂静注后若心律控制不满意，可间隔30min，再静注胺碘酮150mg追加负荷量2-3次，24h之内总量600-1200mg。根据病情部分患者24h后重叠口服胺碘酮600mg，d，1周后减为400mg/d，2周后减至200mg／d维持。结果有效率89．52％，副反应12．10％。结论胺碘酮治疗老年慢性心力衰竭合并快速心律失常安全有效。Objective To observe the clinical effectiveness of amiodarone on rapid cardiac arrhythmias in the elderly with heart failure. Methods 124 patients with chronic heart failure combined with rapid cardiac arrhythmia, aged （79±6.3） （70-93） underwent intravenous infusion of 150 mg amiodarone in 10 minutes, followed by 1 mg/min for 6 hr, and then intravenous infusion with a maintenance dose of 0.5 mg/min for 24-48 hr. If the cardiac arrhythmia was not still satisfactorily controlled after the first dose, additional 150 mg amiodarone could be repeated every other 30 min for 2-3 times until the total dose within 24 h reached 600-1 200 mg. When necessary amiodarone of the overlapped daily dosage of 600 mg could be given orally for 7 days, the dosage was reduced to 400 mg/d l week later, and then to an oral maintenance dose of 200 mg per day 2 weeks later. Results Most of the patients had their cardiac arrhythmias stopped or conversed to sinus rhythm with an effective rate of 89.52%, and a conversion rate of 76.09%. The incidence of side effects （hypotension and sinus bradycardia） was 12.10%. Conclusion A safe drug, amiodarone is effective in treatment of rapid cardiac arrhythmia in the elderly patients with chronic heart failure.

关 键 词：胺碘酮 心律失常 心力衰竭 

分 类 号：R541.7[医药卫生—心血管疾病]