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目的探讨胺碘酮治疗老年人心力衰竭合并室性心律失常的有效性和安全性。方法对84例慢性心力衰竭并发有症状的室性心律失常患者,经常规抗心力衰竭治疗同时,先静脉注射胺碘酮l50mg加0.9%氯化钠注射液20mL,静脉注射,然后以1～1.5mg/min维持,6h后减至0.5～1mg/min,(24h总量<1200mg)。时间不超过3～4d。静脉用药同时给子口服胺碘酮,第1周200mg,3次/d,第2周200mg,2次/d,第3周200mg,1次/d。维持4周或长期维持。结果本组病例治疗总有效率为73.8%(62/84)。窦性心律者HR由(97.16±14.53)/min减至(67.48±10.61)/min(P<0.01),QTc由(408±51)ms增至(483±58)ms(P<0.01)。结论胺碘酮治疗老年人慢性心力衰竭合并室性心律失常安全、有效,不良反应轻。
Objective To investigate the efficacy and safety of amiodarone in the treatment of heart failure with ventricular arrhythmia in the elderly. Methods Eighty-four patients with symptomatic ventricular arrhythmias and chronic heart failure were treated with conventional anti-heart failure treatment. Meanwhile, intravenous injection of 20 mL of amiodarone plus 0.9% sodium chloride injection was given intravenously, mg / min, after 6h reduced to 0.5 ~ 1mg / min, (24h total <1200mg). Time does not exceed 3 ~ 4d. Oral administration of intravenous amiodarone at the same time, the first week of 200mg, 3 times / d, the first two weeks of 200mg, 2 times / d, the third week of 200mg, 1 / d. Maintain for 4 weeks or long term. Results The total effective rate of treatment in this group was 73.8% (62/84). The HR of sinus rhythm decreased from (97.16 ± 14.53) / min to (67.48 ± 10.61) / min (P <0.01) and QTc increased from (408 ± 51) ms to (483 ± 58) ms (P <0.01). Conclusions Amiodarone is safe and effective in the treatment of chronic heart failure and ventricular arrhythmia in elderly patients with mild adverse reactions.