CAJ | 학술논문

目的：探讨对老年人急性心肌梗死（acute myocardial infarction，AMI）并快室率心房纤颤（atrial fibrillation，Af）使用胺碘酮的疗效与安全性。方法：选取96例老年AMI并快室率Af患者，静脉加口服胺碘酮治疗，观察复律及维持、心室率控制、血压变化、30 d死亡率及不良反应等。结果：经治疗，96例中82例恢复窦性心律，转复率85．4％（P＜0．01）；8例未转复；6例死亡（4例死于心源性休克，2例死于急性肺水肿）。用药后15 min、l h、2 h、24 h、48 h心室率较用药前明显下降（P＜0．01）。用药前后血压无明显变化（P＞0．05）。2例出现窦性心动过缓，3例出现长R-R间歇，2例出现低血压，4例出现静脉炎，均经调整消失，无其他不良反应。结论：对老年AMI并快速心室率Af患者静脉加口服胺碘酮对控制心室率及复律安全有效。
목적：탐토대노년인급성심기경사（acute myocardial infarction，AMI）병쾌실솔심방섬전（atrial fibrillation，Af）사용알전동적료효여안전성。방법：선취96례노년AMI병쾌실솔Af환자，정맥가구복알전동치료，관찰복률급유지、심실솔공제、혈압변화、30 d사망솔급불량반응등。결과：경치료，96례중82례회복두성심률，전복솔85．4％（P＜0．01）；8례미전복；6례사망（4례사우심원성휴극，2례사우급성폐수종）。용약후15 min、l h、2 h、24 h、48 h심실솔교용약전명현하강（P＜0．01）。용약전후혈압무명현변화（P＞0．05）。2례출현두성심동과완，3례출현장R-R간헐，2례출현저혈압，4례출현정맥염，균경조정소실，무기타불량반응。결론：대노년AMI병쾌속심실솔Af환자정맥가구복알전동대공제심실솔급복률안전유효。
Objective To explore the effects of amiodarone on rapid ventrile rate atrial fibrillation (Af) in elder patients with acute myocardial infarction (AMI). Methods Besides the injection, an oral amiodarone was given to 96 elder patients,observing the condition of converting and maintaining of atrial fibrillation,ventricular rate controlling, blood pressure changing,mortality in 30 days and negative effects in 96 elder patients with AMI and Af. Results Eighty-two cases (84.4%) restore sinus rhythm, the cardioversion rate is 85.4%(P<0.01). 8 cases failed to cardioversion, 6 cases died . The ventricular rate were significantly lowered than before the treatment (P<0.01). All cases appeared no significant changes in blood pressure (P>0.05). Conclusion In AMI, vein plus oral application amiodarone treat the fast ventricular rate is effective and safety for patients with Af.