胺碘酮治疗急性心肌梗死后室上性心律失常的临床观察

目的：探讨胺碘酮治疗急性心肌梗死后室上性心律失常的临床效果。方法： 78例急性心肌梗死后室上性心律失常的患者随机分为胺碘酮组和利多卡因组各39例，分别给予胺碘酮和利多卡因治疗。根据24 h动态心电图观察两组治疗后7 d 24 h内室性心律失常发作次数、QRS波时间、PR间期，比较两组疗效和不良反应发生情况。结果：治疗后，胺碘酮组总有效率为94.87%，明显高于利多卡因组82.05%（P〈0.05）；两组在室性心律失常发作次数、QRS波时间上均较治疗前明显改善，且胺碘酮组改善情况明显优于利多卡因组（P〈0.05）；胺碘酮组不良反应发生率为17.95%，明显低于利多卡因组33.33%（P〈0.05）。结论： 胺碘酮治疗急性心肌梗死后室上性心律失常安全有效，可显著提高治愈率，减少病死率，且不良反应明显低于利多卡因，值得临床推广。

Clinical Study of Amiodarone in the Treatment of Acute Myocardial Infarction Ventricular Arrhythmia

Objective：：To evaluate the clinical efficacy of amiodarone in the treatment of acute myocardial infarction ventricular arrhythmia. Methods：78 acute myocardial infarction ventricular arrhythmia patients were selected in our hospital from January 2011 to December 2012, and were randomly divided into amiodarone group and lidocaine group with 39 cases in each group. The therapeutic effect was observed according to 24h dynamic electrocardiogram in the two groups after treatment, and 24h chamber arrhythmia time frequency, QRS wave （s）, PR interval （s） and the occurrence of adverse reactions, observed after treatment. Results：After the treatment, the total effective rate was significantly higher （94.87%） in amiodarone group, than that （82.05%） in lidocaine group, and the difference was statistically significant （P〈0.05）; after treatment, the onset times of the two groups and QRS waves of ventricular arrhythmias were significantly improved, and the improving condition of amiodarone group was obviously better than that of lidocaine group, and there was significant difference （P〈0.05）; the incidence of adverse reaction was significantly lower （17.95%） in amiodarone group than that （33.33%） in lidocaine group, and the difference was statistically significant （P〈0.05）. Conclusion：Amiodarone in the treatment of acute myocardial infarction ventricular arrhythmia was safe and effective, and could significantly improve the cure rate of the patients, reduce the mortality rate with fewer adverse reactions than lidocaine, and was therefore worth the clinical promotion.