两种不同剂量胺碘酮对心力衰竭并发快速房颤患者的临床疗效分析医学论文

两种不同剂量胺碘酮对心力衰竭并发快速房颤患者的临床疗效分析_医学论文 【关键词】 胺碘酮；心房颤动；心力衰竭,充血性；心率［摘要］ 目的 探讨不同剂量胺碘酮，对充血性心力衰竭伴快速心房颤动患者的有效性

两种不同剂量胺碘酮对心力衰竭并发快速房颤患者的临床疗效分析_医学论文 【关键词】 胺碘酮；心房颤动；心力衰竭,充血性；心率 ［摘要］ 目的 探讨不同剂量胺碘酮，对充血性心力衰竭伴快速心房颤动患者 的有效性及安全性。方法 选取36例快速房颤患者(心室率>120 bpm，心功能 NYHA分级≥Ⅱ级)，随机分成两个不同剂量组，每组18例。两组每次静脉给予 的负荷剂量分别为75 mg、150 mg，首次给予胺碘酮(生理盐水稀释成20 ml)缓 慢静脉注射15 min，如不转复为窦性心律，以相同的剂量每30 min重复一次 达4次。结果 两组控制房颤伴快速心室率的总有效率分别为69%、 77%(P>0.05)。两组心室率在用药30 min后平均下降幅度分别为 (6.12±6.24)bpm、(15.09±8.98)bpm，两组比较差异有统计学意义(P<0.01)， 用药1 h后平均下降幅度分别为(13.62±10.87)bpm、 (19.56±12.38)bpm(P<0.01)，用药2 h后平均下降幅度分别为 (30.69±21.25)bpm、(28.57±13.46)bpm(P>0.05)。两组用药后Q-T间期、血 压差异无统计学意义(P>0.05)。患者均无严重心律失常发生，未诱发或加重心 功能不全。结论 静脉应用两种不同剂量胺碘酮均能快速、安全、有效控制充血 性心力衰竭并发快速心房颤动患者心室率，并能使部分患者转复。较大剂量组 能够更快控制房颤患者心室率，但不良反应发生率提高。 ［关键词］ 胺碘酮；心房颤动；心力衰竭，充血性；心率 Clinical evaluation on intravenous amiodarone with two doses for congestive heart failure with rapid atrial fibrillation ［Abstract］ Objective To evaluate efficacy and safety of intravenous amiodarone with two does for congestive heart failure with rapid atrial fibrillation.Methods Thirtysix patients with rapid atrial fibrillation (ventricular rate >120 beats per minute and cardiac function≥gradeⅡ) were divided into two groups. Agroup has 18 patients. The bolus dosage of group 1and guorp 2is 75 mg and 150 mg in turn. The first bolus of amiodarone was given intravenously,repeated with the same dose half an hour for four times if no efficacy shown.Results Total efficacy rate of the two groups was 69%,77%,respectively(P>0.05). The decrease amplitude of ventricular rate after the first bolus was (6.12±6.24)bpm,(15.09±8.98)bpm,respectively. Very significant difference was found between group 1and group 2. After the second bolus it was (13.62±10.87)bpm,(19.56±12.38)bmp respectively (P<0.01). After the fourth bolus it was (30.69±21.25)bpm,(28.57±13.46) bpm.Respectively (P>0.05). There was no significant difference on Q-T interval blood pressure after injection in the two groups. There was neither severe arrhythmia nor induced or worsened heart dysfunction among the 36