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目的:观察胺碘酮在快速心房颤动(房颤)伴急性充血性心力衰竭患者的临床疗效。方法:26例快速房颤伴急性充血性心力衰竭患者静脉应用胺碘酮,先静脉注射负荷量后,继以静脉滴注维持,观察房颤转复、心室率控制及不良反应。结果:26例患者用药后15 min,1 h、2 h、24 h心室率分别为(140.1±18.3)、(127.7±16.8)、(104.9±15.4)、(82.1±20.5)次/min,较用药前(149.6±19.7)次/min明显下降(P<0.01)。其中15例患者(58.5%)在24 h内转为窦性心律,3例出现窦性心动过缓,经停药或减药后恢复,2例出现症状性低血压,无心衰加重表现。结论:静脉应用胺碘酮能迅速、安全、有效地控制快速房颤伴急性充血性心力衰竭患者的快速心室率,尤其适合并发急性冠状动脉综合征及原发性高血压的患者。
Objective: To observe the clinical effect of amiodarone in patients with rapid atrial fibrillation (AF) and acute congestive heart failure. Methods: Amiodarone was intravenously administered to 26 patients with acute atrial fibrillation and acute congestive heart failure. After intravenous injection of the drug, intravenous infusion of amiodarone followed the maintenance of atrial fibrillation and ventricular rate control and adverse reactions. Results: The ventricular rate was (140.1 ± 18.3), (127.7 ± 16.8), (104.9 ± 15.4) and (82.1 ± 20.5) times / min at 15 min, 1 h, 2 h and 24 h after treatment in 26 patients Before treatment (149.6 ± 19.7) times / min decreased significantly (P <0.01). Among them, 15 cases (58.5%) were converted to sinus rhythm within 24 hours, 3 cases had sinus bradycardia, and recovered after stopping or reducing medication. Symptomatic hypotension was found in 2 cases and showed no worsening of heart failure. Conclusion: Intravenous amiodarone can rapidly, safely and effectively control the rapid ventricular rate in patients with acute atrial fibrillation and acute congestive heart failure, especially in patients with acute coronary syndrome and essential hypertension.