胺碘酮对于急性心梗后室性早搏的临床疗效及对心功能的影响

目的:观察胺碘酮对急性心肌梗死(AMI)后室性早搏的疗效及对患者心功能的影响。方法:选择本院的94例AMI后室性早搏患者,患者被分为常规治疗组(给予常规利多卡因治疗),胺碘酮组(在常规治疗组的基础上给予胺碘酮治疗);治疗14d后,对比两组患者的疗效,观察两组患者治疗前后心功能等指标的情况及治疗后不良反应率。结果:胺碘酮组治疗总有效率显著高于常规治疗组(97.87%比74.47%,P=0.001)。治疗后,与常规治疗组比较,胺碘酮组左室射血分数(LVEF)(0.49±0.06)比(0.64±0.07)]、左室短轴缩短率(LVFS)(0.43±0.05)比(0.57±0.06)]、二尖瓣舒张早期峰值流速与晚期峰值流速的比值E/A(0.88±0.07)比(0.98±0.11)]均显著提高,心室率(128.47±15.34)次/min比(86.49±14.96)次/min]、QTc离散度(49.51±11.96)ms比(41.09±11.73)ms]、室性早搏次数(21.05±6.91)次/h比(12.07±5.47)次/h]均显著下降,P均=0.001。两组不良反应率无统计学差异(P=0.064)。结论:胺碘酮结合利多卡因治疗急性心梗后室性早搏疗效显著,可显著降低心率,改善心功能,且用药安全。

Therapeutic effect of amiodarone on premature ventricular contraction after acute myocardial infarction and its impact on cardiac function

Objective:To observe therapeutic effect of amiodarone on premature ventricular contraction(PVC)after acute myocardial infarction(AMI)and its impact on cardiac function.Methods:A total of 94 patients with PVC after PCI treated in our hospital were divided into routine treatment group(received routine lidocaine treatment)and amiodarone group(received amiodarone based on routine treatment group).After 14d treatment,therapeutic effect,cardiac indexes etc.before and after treatment,and incidence rate of adverse reactions after treatment were observed and compared between two groups.Results:Total effective rate of amiodarone group was significantly higher than that of routine treatment group(97.87%vs.74.47%,P=0.001).Compared with routine treatment group after treatment,there were significant rise in LVEF(0.49±0.06)vs.(0.64±0.07)],left ventricular fractional shortening(LVFS)(0.43±0.05)vs.(0.57±0.06)]and mitral early diastolic peak velocity/late diastolic peak velocity(E/A)(0.88±0.07)vs.(0.98±0.11)],and significant reductions in ventricular rate(128.47±15.34)beats/min vs.(86.49±14.96)beats/min],QTc dispersion(49.51±11.96)ms vs.(41.09±11.73)ms]and PVC times(21.05±6.91)beats/h vs.(12.07±5.47)beats/h]in amiodarone group,P=0.001 all.There was no significant difference in incidence rate of adverse reactions between two groups,P=0.064.Conclusion:Amiodarone combined with lidocaine possesses significant therapeutic effect premature ventricular contraction after AMI.It can significantly reduce ventricular rate,and improve cardiac function with good safety.