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目的探讨静脉滴注胺碘酮治疗急性心肌梗死并新发房颤的临床疗效及其安全性。方法 60例急性心肌梗死伴新发快速房颤,静脉应用胺碘酮,先静脉推注负荷量后,继以静脉滴注维持,观察房颤转复、心室率控制、血压及Q-T间期变化情况及药物不良反应。结果 60例患者用药后0.25、1、2、24 h的心室率分别是(136.2±19.4)、(119.4±15.9)、(101.5±14.1)、(82.7±20.8)次·min~(-1),较用药前心室率(140.3±17.5)次·min~(-1)明显下降(P<0.01);44例(占73.3%)转复窦性心律;血压、Q-T间期在用药前后差异无统计学意义(P>0.05)。本组患者中1例出现窦性心动过缓;1例出现长R-R间期,经停药后恢复正常;1例用药期间发生静脉炎。结论静脉滴注胺碘酮治疗急性心肌梗死并新发快速房颤是安全及有效的。
Objective To investigate the clinical efficacy and safety of intravenous amiodarone in the treatment of acute myocardial infarction and new-onset atrial fibrillation. Methods Sixty patients with acute myocardial infarction and new-onset acute atrial fibrillation were treated with intravenous amiodarone and intravenous bolus injection followed by intravenous infusion to observe the changes of atrial fibrillation, ventricular rate control, blood pressure and QT interval Situation and adverse drug reactions. Results The ventricular rates of the 60 patients at the time points of 0.25, 1, 2 and 24 h were (136.2 ± 19.4), (119.4 ± 15.9), (101.5 ± 14.1) and (82.7 ± 20.8) (140.3 ± 17.5) · min -1 (P <0.01), and 44 cases (73.3%) had sinus rhythm. Blood pressure and QT interval before and after treatment were significantly lower than those before treatment Statistical significance (P> 0.05). One patient in our group had sinus bradycardia; one patient had a long R-R interval and returned to normal after stopping the drug; one patient developed phlebitis during the treatment. Conclusion Intravenous amiodarone is safe and effective in the treatment of acute myocardial infarction and new-onset rapid atrial fibrillation.