胺碘酮对预防老年急性心肌梗死后猝死的疗效研究

目的研究在老年急性心肌梗死后猝死预防中胺碘酮对降低病死率、减少除颤次数和不良反应发生率的疗效。方法采用前瞻性随机对照原则，将老年急性心肌梗死后猝死患者60例，分为胺碘酮治疗试验组和常规治疗组（对照组）．胺碘酮治疗试验组30例，对照组30例，比较两组的死亡率、心律失常控制、除颤次数和不良反应例数。结果胺碘酮治疗试验组和对照组除颤次数分别为（1．40±0．3）次和（3．65±0．4）次（P〈0．01）；胺碘酮治疗试验组和对照组对心律失常控制总有效率分别为90％和83.33％；病死率分别为36．67％和70．00％（P〈0．05）；胺碘酮治疗试验组不良反应5例。结论老年急性心肌梗死后猝死急救治疗中，预防性应用胺碘酮可显著降低除颤器的使用率，增加抢救成功率，无严重不良反应。

The effect of amiodarone in the prevention of sudden death of elderly patients with acute myocardial infarction

Objective To explore the effect of prophylactic application of amiodarone in emergency treatment of pa- tients with sudden death of elderly patients with acute myocardial infarction. Methods Sixty patients with sudden death of elderly patients with acute myocardial infarction were randomly divided into two groups： amiodarone prophy- lactic application group and routine treatment group with 30 patients in each group.The times of defibrillation and cas es of death and adverse reaction were statistically analyzed. Results The times of defibrillation were （1.40±3.3） in amio darone prophylactic application group and （3.65±0.4） in routine treatment group（P 〈 0.01 ）.The death rate were 36.67% in amiodarone prophylactic application group and 70.00% in routine treatment group（P 〈 0.05）. Adverse reactions were observed in 5 patients in amiodarone prophylactic applicanon group. Conclusion Prophylactic application of amio- darone in emergency treatment of patients with sudden death of elderly patients with acute myocardial infarction can significantly decrease the utilization rate of defibrillator, increase the rate of successful rescue with no severe adverse reaction.