胺碘酮治疗急性心肌梗死并室上性心律失常的临床疗效  

Clinical efficacy of amiodarone in the treatment of acute myocardial infarction with supraventricular arrhythmias

作　　者：马国强 周臻臻 杜永良 MA Guoqiang;ZHOU Zhenzhen;DU Yongliang(Department of Cardiology,Ru Shan People′s Hospital,Shandong Province,Rushan 264500,China;不详)

机构地区：[1]山东省乳山市人民医院心内一科,264500 [2]山东省乳山市人民医院神经内二科,264500

出　　处：《临床合理用药杂志》2024年第6期9-12,共4页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的探讨胺碘酮治疗急性心肌梗死(AMI)并室上性心律失常的临床疗效。方法选取2021年6月—2022年6月乳山市人民医院收治的AMI并室上性心律失常患者90例作为研究对象,以双色球法分为利多卡因组(n=45)与胺碘酮组(n=45)。利多卡因组给予利多卡因治疗,胺碘酮组给予胺碘酮治疗,2组均于心率稳定后停药。比较2组临床疗效,治疗前与治疗结束后心功能指标[左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)]、室上性心律失常发作次数及发作持续时间、心电图[心率、校正后QT间期(QTc)、QT间期离散度(QTd)]及不良反应。结果胺碘酮组总有效率高于利多卡因组(97.78%vs.82.22%,χ^(2)=4.444,P=0.035)。治疗结束后,2组LVEF高于治疗前,LVEDD、LVESD小于治疗前,且胺碘酮组升高/缩小幅度大于利多卡因组(P<0.01);2组室上性心律失常发作次数少于治疗前,室上性心律失常发作持续时间短于治疗前,且胺碘酮组变化幅度大于利多卡因组(P<0.01);2组心率、QTd低于治疗前,QTc高于治疗前,且胺碘酮组降低/升高幅度大于利多卡因组(P<0.05或P<0.01)。利多卡因组与胺碘酮组不良反应总发生率比较,差异无统计学意义(13.33%vs.4.44%,χ^(2)=1.235,P=0.266)。结论胺碘酮治疗AMI并室上性心律失常可较好地改善患者的心功能及心室肌复极离散程度,同时减少室上性心律失常发作次数,缩短发作持续时间,进而增强临床疗效,但不会增加不良反应发生风险,安全性较高。Objective To explore the clinical efficacy of amiodarone in the treatment of AMI with supraventricular arrhythmia.Methods Ninety patients with AMI and supraventricular arrhythmia admitted to Ru Shan People′s Hospital from June 2021 to June 2022 were selected as the study subjects,and they were divided into the lidocaine group(n=45)and the amiodarone group(n=45)by the two-colour balloon method.The lidocaine group was treated with lidocaine and the amiodarone group was treated with amiodarone,and both groups were discontinued after heart rate stabilisation.Clinical efficacy,cardiac function indexes(LVEF,LVEDD,LVESD),number and duration of supraventricular arrhythmia,electrocardiogram(heart rate,QTc,QTd)before and at the end of treatment,and adverse reactions were compared between the two groups.Results The total effective rate in the amiodarone group was higher than lidocaine group(97.78%vs.82.22%,χ^(2)=4.444,P=0.035).At the end of treatment,LVEF of the two groups was higher than before treatment,LVEDD and LVESD were smaller than before treatment,and the amplitude of increase/decrease in the amiodarone group were larger than the lidocaine group(P<0.01);Number of supraventricular arrhythmia of the two groups was less than pre-treatment,the duration of supraventricular arrhythmia was shorter than pre-treatment,and the amplitude of the change in the amiodarone group were larger than the lidocaine group(P<0.01);Heart rate and QTd in the two groups were lower than before treatment,QTc was higher than before treatment,and the decrease/increase in the amiodarone group were greater than the lidocaine group(P<0.05 or P<0.01).There was no statistically significant difference in the total incidence of adverse reactions between the lidocaine group and the amiodarone group(13.33%vs.4.44%,χ^(2)=1.235,P=0.266).Conclusion Amiodarone in the treatment of AMI with supraventricular arrhythmia can better improve the cardiac function and the degree of ventricular myocardial repolarisation,and at the same time reduce the number of su

关 键 词：急性心肌梗死 室上性心律失常 胺碘酮 利多卡因 心功能 心电图 安全性 

分 类 号：R541.7[医药卫生—心血管疾病] R542.22[医药卫生—内科学]