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目的探讨胺碘酮(Amiodarone,AM)静脉注射治疗急性心肌梗死危及生命的室性心律失常的疗效与安全性。方法21例急性心肌梗死(AMI)后反复发作持续室性心动过速(VT)/心室颤动(VF)患者,男17例,女4例,年龄56～79(53.5±11.7)岁,对常规抗心律失常药物无效,静脉注射AM首剂150～300mg,10min内静脉注入,继以1.0～1.5mg/min静注维持,以后根据病情加减,静脉给药同时口服胺碘酮600mg/24h,若第一次负荷量后,心律失常控制不满意,可每隔30min再加注75～150mg,直至VT、VF消失为有效。结果第1个24hAM静脉用量(1482.6±304.5)mg,心律失常控制率62%(13/21),72h全部控制。1例大面积心肌梗死15d后再发VT、VF,加用AM后获得控制,2例死于心源性休克。结论静脉注射(AM)治疗AMI后心律失常,安全有效。
Objective To investigate the efficacy and safety of amiodarone (AM) intravenous injection in the treatment of life-threatening ventricular arrhythmias in acute myocardial infarction. Methods Twenty-one patients with persistent ventricular tachycardia (VT) / ventricular fibrillation (VF) after 21 consecutive AMI were enrolled in this study. There were 17 males and 4 females, aged 56-79 years (53.5 ± 11.7 years) Antiarrhythmic drugs ineffective intravenous injection of AM first dose of 150 ~ 300mg, 10min intravenous injection, followed by 1.0 ~ 1.5mg / min intravenous maintenance, after the addition or subtraction according to the disease, intravenous administration of amiodarone 600mg / 24h, If the first load, the arrhythmia control is not satisfied, can be every 30min and then add 75 ~ 150mg, until VT, VF disappear is valid. Results The first 24hAM intravenous dose (1482.6 ± 304.5) mg, arrhythmia control rate of 62% (13/21), 72h all control. One case of large myocardial infarction 15 days after the recurrence of VT, VF, plus AM after gain control, 2 patients died of cardiogenic shock. Conclusion Intravenous injection (AM) is safe and effective in the treatment of arrhythmia after AMI.