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目的评价胺碘酮治疗急性心肌梗死合并心房颤动的临床疗效及安全性。方法入选51例急性心肌梗死合并心房颤动的老年患者,随机分为试验组26例和对照组25例。试验组给予胺碘酮100 mg+0.9%氯化钠20 m L,静脉缓慢注射6 min,后改静脉滴注0.5~1.0 mg·min-1,直至恢复窦性心律。对照组给予毛花苷丙0.4 mg+5%葡萄糖20 m L,静脉缓慢推注5min注射完毕。比较2组24 h心房颤动控制情况、不良反应发生情况以及心房颤动转复后1个月窦性心律维持效果。结果试验组治疗后24 h心房颤动控制14例,控制率为53.8%;对照组心房颤动控制6例,控制率为24.0%,试验组控制率显著高于对照组(P<0.05)。转复窦性心律后,试验组1个月内窦性心律维持有效率为88.5%(23/26),显著高于对照组的48.0%(12/25)。试验组药品不良反应发生率为7.6%,显著低于对照组的40.0%(P<0.05)。结论胺碘酮治疗急性心肌梗死合并心房颤动的疗效优于毛花苷丙,且不良反应发生率低。
Objective To evaluate the clinical efficacy and safety of amiodarone in the treatment of acute myocardial infarction complicated with atrial fibrillation. Methods A total of 51 elderly patients with acute myocardial infarction complicated by atrial fibrillation were randomly divided into experimental group (n = 26) and control group (n = 25). The experimental group was given amiodarone 100 mg + 0.9% sodium chloride 20 m L, slow intravenous injection 6 min, then changed intravenous drip 0.5 ~ 1.0 mg · min-1 until sinus rhythm. The control group was given 0.4 mg of curcumin + 5% glucose 20 m L, intravenous bolus injection 5min slowly. The 24-hour atrial fibrillation control, adverse reactions, and maintenance of sinus rhythm in one month after the atrial fibrillation were reversed were compared between the two groups. Results In the experimental group, 14 cases of atrial fibrillation were controlled at 24 hours after treatment. The control rate was 53.8%. The control group was 6 cases with atrial fibrillation control rate of 24.0%. The control rate of the experimental group was significantly higher than that of the control group (P <0.05). After the sinus rhythm was reversed, the maintenance rate of sinus rhythm in trial group was 88.5% (23/26) within one month, which was significantly higher than that in control group (48.0%, 12/25). The adverse drug reaction rate in the experimental group was 7.6%, which was significantly lower than that in the control group (40.0%, P <0.05). Conclusions The efficacy of amiodarone in the treatment of acute myocardial infarction with atrial fibrillation is superior to that of clytidin, and the incidence of adverse reactions is low.