艾司洛尔联合胺碘酮治疗急性冠脉综合征后心室电风暴的临床研究  

The clinical study of efficacy and safety of combined Esmolol and Amiodarone on ventricular electrical storm in patients with acute coronary syndrome

作　　者：郭胜红[1] 柳林伟[1] 夏豪[2] 

机构地区：[1]天门市第一人民医院药剂科,湖北省天门市431700 [2]武汉大学人民医院心血管内科

出　　处：《中国心血管病研究》2015年第8期698-702,共5页Chinese Journal of Cardiovascular Research

基　　金：基金项目：国家自然科学基金（项目编号：81270184）

摘　　要：目的探讨艾司洛尔联合胺碘酮治疗急性冠脉综合征（ACS）后心室电风暴的临床疗效和安全性。方法选取2010年3月至2015年1月在天门市第一人民医院心内科住院诊断ACS后并发心室电风暴患者120例，将其随机分为艾司洛尔联合胺碘酮治疗组（联合组）60例和胺碘酮治疗组（对照组）60例。统计患者基本临床资料、入院24h内实验室检查结果和超声心动图，观察两组治疗前后的有效率、收缩压、舒张压、心率、QT间期离散度和主要不良反应发生率，比较治疗前后上述指标的变化并评估其安全性。结果联合组对ACS后心室电风暴治疗有效率显著高于对照组（88．3％比63．3％，P〈0．05）；两组患者收缩压[（105±9）mmHg比（127＋13）mmHg，（110±11）mmHg比（129±14）mmHg]、舒张压[（70±4）mmHg比（83±5）mmHg，（75±5）mmHg比（85±7）mmHg]、心率[（66±5）次／min比（119±14）次／min，（98±7）次／min比（116±12）次／min]及QT间期离散度[（31±7）ms比（59±17）ms，（35±9）ms比（57±15）ms]治疗后较治疗前相比均有明显下降（P〈0．05）。治疗后联合组与对照组相比，收缩压[（105±9）mmHg比（110±11）mmHg]、舒张压[（70±4）mmHg比（75±5）mmHg]未见统计学差异（P〉0．05）；心率[（66±5）次／min比（98±7）次／min]、QT间期离散度[（31±7）ms比（35±9）ms]差异有统计学意义（P〈0．05）；联合组与对照组的安全性比较未见统计学差异（23．3％比30．0％，P〉0．05）。结论艾司洛尔联合胺碘酮治疗急性冠脉综合征后心室电风暴效果显著，能快速有效地治疗心室电风暴，且无明显副作用，值得临床推广和进一步探讨。Objective To evaluate the clinical efficacy and safety of combined Esmolol and Amiodarone on ventricular electrical storm in patients with acute coronary syndrome（ACS）. Methods 120 patients of ventricu- lar electrical storm in the patients with ACS during March 2010 to January 2015 in our hospital were divided into two groups, combined Esmolol and Amiodarone group （combining group） 60 cases and Amiodarone group（control group） 60 cases. The basic clinical data and laboratory results were collected within 24 h. The cardiac function tests were performed for all the patients during the period of hospitalization after admission. Their echocardiographic parameters were analyzed. The success rate of electroversion and adverse reactions were observed in two groups. In addition, systolic blood pressure （SBP）, diastolic blood pressure （DBP）, heart rate （HR）, and the QTd were also observed in two groups. Then the clinical efficacy was observed, and safety was evaluated. Results The success rate of terminating ventricular fibrillation（VF） and ventricular tachycardia（VT） was significantly higher in combin- ing group than that in amiodarone group （88.3% vs 63.3%, P〈0.05）. The SBP [ （105±9）mm Hg vs （127±13）mm Hg, （ 110±11 ）mm Hg vs （ 129±14）mm Hg], DBP[ （70±4）mm Hg vs （83±5）mm Hg, （75±5）mm Hg vs （85±7）mm Hg], HR[（66±5）bpm vs （ll9±14）bpm, （98±7）bpm vs （116±12）bpm] and the QTd[（31±7）ms vs （59±17）ms, （35±9）ms vs （57±15）ms] had statistical significance in both of two groups between before and after treatment （P〈 0.05）. The SBP（ 105±9）mm Hg vs （110±11 ）mm Hg and DBP（70±4）mm Hg vs （75±5）mm Hg had no statistical significance between combining group and control group after treatment （P〉0.05）. The HR （66±5）bpm vs （98±7）bpm and the QTd（31±7）ms vs （35±9）ms in combining group were lower than those in control group after treatment（P〈 0.05 ）. The combining group and co

关 键 词：艾司洛尔 胺碘酮 急性冠脉综合征 电风暴 疗效 安全性 

分 类 号：R543.3[医药卫生—心血管疾病]