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目的:分析我院静脉用胺碘酮不良反应QT间期延长的可能影响因素,为临床更好发挥胺碘酮作用,减少不良反应提供依据。方法:回顾性分析我院2011年6月10日至2012年5月10日期间静脉用胺碘酮患者的临床资料,采用描述性研究方法分析我院静脉用胺碘酮患者的不良反应,然后根据是否用药后出现经心率校正的QT(QTc)间期延长将患者分为两组,QTc间期延长组(L-QTc)和QTc间期非延长组(N-QTc),采用单因素及多因素Logistic回归分析的方法分析患者用药后出现长QTc间期的可能危险因素。结果:静脉使用胺碘酮患者共计534例,其中419例为心脏术后发生快速性心律失常应用。去除胺碘酮应用后缺乏心电图的病例,最终纳入病例243例,应用胺碘酮后发生肝功能损害18例(7.4%),严重血压降低5例(2.1%),QTc间期延长62例(25.5%),静脉炎2例(0.8%),无心动过缓或房室传导阻滞的发生。经单因素和多因素Logistic逐步回归分析显示,手术后急性肾损伤是QTc间期延长的危险因素。结论:我院静脉用胺碘酮主要用于心脏手术后发生快速性心律失常的患者,QTc间期延长发生率较高,心脏术后急性肾损伤是QTc间期延长的独立危险因素。
Objective: To analyze the possible influencing factors of QT prolongation of intravenous amiodarone in our hospital, and to provide a basis for clinical use of amiodarone to reduce adverse reactions. Methods: The clinical data of patients with intravenous amiodarone in our hospital from June 10, 2011 to May 10, 2012 were retrospectively analyzed. The adverse reactions of intravenous amiodarone in our hospital were analyzed by descriptive method. Then, The patients were divided into two groups according to QT (QTc) interval prolongation after treatment: QTc interval prolongation (L-QTc) and QTc interval non-prolongation (N-QTc) Multivariate Logistic regression analysis of patients with long QTc after drug use may be risk factors. Results: A total of 534 intravenous amiodarone patients were used, 419 of whom were patients with tachyarrhythmia after cardiac surgery. After removing amiodarone, electrocardiogram (ECG) was removed and 243 patients were finally enrolled. Eighteen patients (7.4%) had liver dysfunction after amiodarone administration, 5 patients (2.1%) had severe blood pressure decrease, and QTc interval prolonged by 62 patients 25.5%), phlebitis in 2 cases (0.8%), no bradycardia or atrioventricular block occurred. After univariate and multivariate Logistic stepwise regression analysis, acute renal injury after surgery was a risk factor for QTc interval prolongation. CONCLUSION: Amiodarone intravenously is mainly used in patients with tachyarrhythmia after cardiac surgery. QTc interval prolongation is a high incidence. Acute renal injury after cardiac surgery is an independent risk factor for QTc prolongation.