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目的:探讨心肌梗死后并发顽固室性心动过速(VT)和/或心室颤动(VF)静脉注射胺碘酮(Am)的疗效。方法:本组28例均为冠心病患者,男21例,女7例,年龄43～68岁,平均57±11.6岁。左室射血分数30%～48%,平均38±4.2%,静脉注射Am首剂3～5mg/kg,10～20分钟内注入,继之以0.75～1 mg/min维持,第一个24小时静脉给Am总量1425.6～3510 mg,平均1850±560 mg,同时给予口服Am,必要时可每隔30分钟再给Am 75～150 mg,追加负荷量,依据病情逐渐减停。以VT和VF消失为有效。结果:15/28例患者24小时VT和/或VF获得控制,占54%,72/小时全部控制,96小时1例复发,再次追加Am后获得控制。随访22个月,1例猝死,1例死于心力衰竭。结论:静脉注射Am对心肌梗死并发顽固VT或VF治疗安全有效。预防心律失常复发需长期口服Am治疗。有条件者可植入埋藏自动复律式除颤器(ICD)。
Objective: To investigate the efficacy of intravenous Amiodarone (Am) intravenously in patients with persistent ventricular tachycardia (VT) and / or ventricular fibrillation (VF) after myocardial infarction. Methods: 28 cases were patients with coronary heart disease, 21 males and 7 females, aged 43 to 68 years, mean 57 ± 11.6 years. Left ventricular ejection fraction of 30% to 48%, an average of 38 ± 4.2%, intravenous injection of Am first dose of 3 ~ 5mg / kg, 10 to 20 minutes, followed by 0.75 ~ 1 mg / min maintenance, the first 24 Amour intravenous Amounts of 1425.6 ~ 3510 mg, an average of 1850 ± 560 mg, given oral Am, if necessary, can be given every 30 minutes Am 75 ~ 150 mg, additional load, according to the disease gradually stop. VT and VF disappear as valid. RESULTS: Twenty-eight of the 28 patients received control of VT and / or VF at 24 hours, accounting for 54% of the total, 72% of the patients in the control group, and 1 patient relapsed after 96 hours. During the follow-up of 22 months, one died of sudden death and one died of heart failure. Conclusions: Intravenous Am is safe and effective in the treatment of myocardial infarction with stubborn VT or VF. Prevention of recurrent arrhythmias requires long-term oral Am therapy. Implantable buried defibrillator (ICD) is available.