艾司洛尔联合胺碘酮治疗急性冠脉综合征后心室电风暴的临床研究

【摘要】目的：探讨艾司洛尔联合胺碘酮治疗急性冠脉综合征(ACS)后心室电风暴的临床疗效和安全性。方法：选择选取2010年3月至2015年1月在我院心内科住院诊断ACS后并发心室电风暴患者120例,将其随机分为艾司洛尔联合胺碘酮治疗组(联合组)60例和胺碘酮治疗组(对照组)60例。统计患者基本临床资料及入院24h内实验室检查结果、超声心动图,观察两组治疗前后的有效率,收缩压、舒张压、心率、QT间期离散度和主要不良反应发生率,并比较治疗前后上述指标的变化并评估其安全性。结果：联合组对ACS后心室电风暴治疗有效率显著高于对照组(P < 0.05)；两组患者收缩压、舒张压、心率及QT间期离散度治疗后较治疗前相比均有明显下降(P < 0.05)；治疗后联合组收缩压、舒张压与对照组相比较无统计学差异(P >0.05)；治疗后联合组心率、QT间期离散度与对照组相比较有统计学差异(P <0.05)；联合组与对照组的安全性无显著差异(P >0.05)。 结论：艾司洛尔联合胺碘酮治疗治疗急性冠脉综合征后心室电风暴效果显著,能快速有效地治疗心室电风暴,且无明显副作用,值得临床推广和进一步的探讨。

The Clinical study of efficacy and safety of combined esmolol and amiodarone on ventricular electrical storm in patients with acute coronary syndrome

Abstract]Objective To evaluate the clinical efficacy and safety of combined esmolol and amiodarone on ventricular electrical storm in patients with acute coronary syndrome(ACS). Methods 120 patients of ventricular electrical storm in the patients with ACS during March 2011 to January 2015 in our hospital were divided into two groups,combined esmolol and amiodarone group(combining group) 60 cases and amiodarone group(controlSgroup) 60 cases.The Basic clinical data and laboratory results were collected within 24h.The cardiac function tests were performed for all the patients during the period of hospitalization after admission.Their echocardiographic parameters were analyzed.The success rate of electroversion and adverse reactions were observed in two groups.In addition,systolic blood pressure(SBP),Diastolic blood pressure(DBP),heart rate (HR),and the QTd were also observed in two groups.Then the clinical efficacy was observed,and safety was evaluated. Results The success rate of terminating Ventricular fibrillation(VF) and Ventricular tachycardia(VT) was significantly higher in combining group than that in amiodarone group(P<0.05).The SBP,DBP,HR and the QTd had statistical significance in both of two groups between before and after treatment(P<0.05).The SBP and DBP had no statistical significance between combining group and control group after treatment(P>0.05).The HR and the QTd in combining group were lower than those in control group after treatment (P<0.05).The combiningSgroup and control group have no significant differences inSsafety(P>0.05). Conclusion The intravenous injection of combined esmolol and amiodarone is a safe and effective treatment strategy for treating ventricular electrical storm in the patients with ACS.So the esmolol combined with amiodarone is worthySofSclinicalSapplication.