短期静脉应用胺碘酮治疗老年心房颤动的疗效分析.docVIP

短期静脉应用胺碘酮治疗老年心房颤动的疗效分析 【摘要】 　　目的：观察短期静脉应用胺碘酮转复老年心房颤动的效果及安全性。方法：42例新发的老年房颤患者，静脉给予负荷量胺碘酮（150～300 mg），并以1.0～0.5 mg/min静脉维持，观察24h的转复效果及不良反应。结果：33例患者转复窦性心律（82.1%），其中1h内复律3例，1～8h内13例，8～24h内17例，复律后的心率、收缩压和舒张压均显著下降，未复律者的心室率也明显减慢（P0.01）。共出现3例窦性心动过缓，1例频发房性早搏，1例一过性低血压，1例静脉炎。结论：静脉应用胺碘酮转复老年新发房颤的短期成功率较高并且相对安全。 【关键词】 心房颤动 胺碘酮 老年人 　　Effects of intravenous amiodarone in the short term on atrial fibrillation in the aged/ 　　LIU Li|xin, FENG Yan|ling, ZHOU Shu|ming, ZHENG Tao, WANG Ya|ping// 　　Abstract：Objective:To investigate the efficacy and safety of short|term intravenous amiodarone in the management of atrial fibrillation in the aged.Methods:Forty two patients with recent onset (within 24h) atrial fibrillation were treated with loading dose of amiodarone (150～300 mg) intravenously, followed by intravenous infusion of amiodarone with the rate at 1.0～0.5 mg/min.The conversion rate and adverse reactions within 24h were observed.Results:At 24h, sinus rhythm was restored in thirty three patients (82.1%), and at 1h, 1～8h, 8～24h, sinus rhythm was restored in three, thirteen and seventeen patients respectively, there were significant decrease in ventricular rate, systolic pressure and diastolic pressure after conversion to sinus rhythm (P0.01); there was also a significant decreased ventricular rate in those who didnt restore to sinus rhythm (P0.01).Sinus bradycardia was observed in three patients, one patient had frequent atrial premature beats, one patient had transient hypotension and one patient had phlebitis.Conclusion:Short|term intravenous amiodarone has a high conversion rate and relative safety in the treatment of recent onset atrial fibrillation in the aged. 　　Author′s　address：General Hospital of Beijing command of PLA, Beijing 100700, China 　　Key words：Atrial fibrillation; Amiodarone; The aged 　　心房颤动（房颤）是老年人群常见的一种心律失常。欧美国家一般人群的房颤患病率约为0.4%～1%，并且随年龄而递增，80岁以上人群患病率高于8%，其中男性、女性人群的每年发病率分别超过2%和1.5%[1,2]；周自强等报道国内房颤患病率约为0.77%，按标准人口校正后为0.61%，其中60