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目的 :比较胺碘酮与利多卡因治疗急性心肌梗死 (AMI)伴室性早搏 (VPB)的临床疗效。方法 :49例 AMI伴 VPB患者胸痛发作 1h后随机接受胺碘酮 (治疗组 ,n =2 5 )或利多卡因 (对照组 ,n =2 4)治疗。比较两种药物治疗 AMI伴 VPB的有效率、两组室性心动过速与心室颤动、室上性心动过速与心房颤动、心衰、胸痛复发的发生率以及两组的病死率。结果 :两种药物对 VPB的有效率以及两组患者室性心动过速与心室颤动和心衰的发生率无显著差异 (分别 P >0 .0 5 )。胺碘酮治疗组室上性心动过速与心房颤动和胸痛复发的发生率则明显低于对照组 (均 P <0 .0 5 ) ,胺碘酮治疗组的病死率呈降低趋势 ,但差异未达到统计学意义 (P >0 .0 5 )。结论 :胺碘酮是一种治疗 AMI伴 VPB安全、有效的药物 ,并能降低 AMI患者室上性心动过速与心房颤动和胸痛复发的发生率。
Objective: To compare the clinical efficacy of amiodarone and lidocaine in the treatment of acute myocardial infarction (AMI) with ventricular premature beats (VPB). Methods: Ninety-nine AMI patients with VPB were randomized to receive amiodarone (n = 25) or lidocaine (n = 24) at 1 h after onset of chest pain. Compare the effectiveness of two drugs in treating AMI with VPB, the incidence of ventricular tachycardia and ventricular fibrillation, supraventricular tachycardia and atrial fibrillation, heart failure and recurrent chest pain, and the mortality of the two groups. RESULTS: The efficacy of the two drugs on VPB and the incidence of ventricular tachycardia and ventricular fibrillation and heart failure in both groups were not significantly different (P> 0.05). Amiodarone group, the incidence of supraventricular tachycardia and atrial fibrillation and chest pain recurrence was significantly lower than the control group (P <0.05), amiodarone treatment group mortality decreased, but the difference Did not reach statistical significance (P> 0.05). Conclusions Amiodarone is a safe and effective drug for the treatment of AMI with VPB and can reduce the incidence of supraventricular tachycardia and atrial fibrillation and recurrent chest pain in patients with AMI.