充血性心力衰竭并有室性心律失常应用胺碘酮的经验  

Clinical Experience of Intravenous Amiodarone in Terminating Congestive Heart Failure with Malignant Ventricular Arrhythmia

作　　者：袁贤奇[1] 宋有城[1] 朱俊[1] 王国干[1] 贺丽霞[1] 谭慧琼[1] 杨艳敏[1] 康连鸣[1] 郝云霞[1] 

机构地区：[1]中国医学科学院

出　　处：《中国循环杂志》2001年第4期262-264,共3页Chinese Circulation Journal

摘　　要：目的：总结充血性心力衰竭（ＣＨＦ）并有快速室性心律失常患者应用胺腆酮的疗效及安全性。　　　　方法：２６例有器质性心脏病，心功能（ＮＹＨＡ）Ⅱ～Ⅲ级，左心室射血分数（ＬＶＥＦ）０．２４±０．０７，伴有室性心动过速（ＶＴ）和（或）心室颤动（ＶＦ）的患者。应用静脉注射胺碘酮首剂３～５ｍｇ／ｋｇ，稀释后１０分内注入，继以０．７５～１．００ｍｇ／ｍｉｎ维持注射，必要时可每隔３０分追加胺碘酮７５～１５０ｍｇ，同时口服胺碘酮每日６００～８００ｍｇ。并逐步减至每日２００ｍｇ维持。出院后随诊观察。　　　　结果：第１个２４小时，１８／２６例心律失常获控制占６９％，静脉注射胺碘酮１２４８．０±１３５．４ｍｇ（１１５６～２１８４ｍｇ），５６小时心律失常全部被控制，血液动力学稳定。患者心功能改善至ＬＶＥＦ　０．３３±０．０９。　　　　结论：静脉注射胺碘酮治疗ＣＨＦ伴ＶＴ和（或）ＶＦ安全有效，用药强调个体化，预防心律失常发作需长期口服胺碘酮。Objective:To determine the efficacy and safety of intravenous amiodarone in term inating congestive heart failure(CHF)with malignant ventricular arrhyth mia Methods:Twenty six patients(17 males a nd 9 females)having CHF with ventricular tachycardia(VT)and/or ventricu lar fibril lation(VF)cardiac function(NYHA)of class Ⅱ or Ⅲ and left ventricular ejection frac tion (LVEF) of 0.24±0.07(0.21-0.45)were en rolled in this study Intravenous loading dose of 3-5 mg/kg of amiodarone was int ially given,and followed by 0.75-1.00 mg /min infusion If VT and(or)VF was uncontr olled,additional bolus of 75-150 mg was repeated every other 30min Oral amiodaro ne of 600-800mg daily was required simul taneously Results:The amiodarone total dose was 1248.0±135.4mg(1 156-2 184mg) The disappearance of arrhythmias was found in 69 %at 24 hours and 100% at 56 h ours All patents had an improved LVEF(0.33±0.09) Conclusion:Intravenous amiodarone has a high efficacy and safety f or CHF with VT and/or VF The dosage of a miodarone varies according to individual s Long term oral of amiodarone is effect ive for the prevention of arrhythmic events

关 键 词：胺碘酮 室性心动过速 充血性心力衰竭 治疗 

分 类 号：R541.61[医药卫生—心血管疾病] R541.71[医药卫生—内科学]