胺碘酮治疗冠心病持续性室性心动过速的临床观察

分析胺碘酮在控制冠心病并发持续性室性心动过速(简称室速)的临床特点。选择冠心病合并持续性室速患者30例,年龄59.78±10.2岁,给与静脉和口服胺碘酮负荷量后计算室速控制率;分析胺碘酮总负荷量与患者的左室舒张期末径(LVEDV)、左室射血分数(LVEF)、有无室壁瘤的关系;观察血药浓度、用药前后(包括合并用药)心率、血压、QTc等的变化及副作用。结果:①胺碘酮对冠心病持续性室速的控制率为90%;②胺碘酮总负荷量14.81±8.89(4.14～48.79)g,静脉负荷时间158±155.79(26～648)h;③胺碘酮负荷用量与LVEF和有无室壁瘤相关,与LVEDV无关;④胺碘酮的有效血药浓度个体差异性大;⑤在治疗期间总副作用发生率16.67%。结论:胺碘酮控制冠心病室速安全有效,胺碘酮负荷总量及有效血药浓度个体差异性大。

Studies of Amiodarone Treatment of Sustained Ventricular Tachycardia in Patients With Coronary Artery Disease

To investigate clinical characteristics of amiodarone treatment of sustained ventricular tachycardia(VT) in patients with coronary artery disease,30 patients with coronary heart disease complicated sustained VT were selected. After intravenous and oral loading amiodarone applied, we evaluated the effect of the therapy of amiodarone for VT and analyzed the relation between amiodarone loading dose and clinical variables such as left ventricular end diastolic volume(LVEDV),left ventricular ejection fraction(LVEF) and the presence of aneurysm. At the same time, parameters included blood pressure, heart rate, PR interval and QTc were monitored. Results:①The effective rate was 90%.②The total amiodarone loading dose was 14.81±8.89 g. ③Amiodarone loading dose was correlated with LVEF and the presence of aneurysm, LVEDV could not influence the loading dose. ④There was individual deference of effective serum concentration of amiodarone.⑤Side effect rate of amiodarone was 16.67%. Conclusion:Amiodarone can be used for effectively and safely controlling VT in patients coronary artery disease . There is individual deference in the amiodarone loading dose and effective serum concentration.