郑斌++++++周旭华

[摘要] 目的 探讨胺碘酮联合盐酸美西律治疗ICU高危快速型心律失常的临床效果。 方法 将92例高危快速型心律失常患者根据随机抽签原则分为治疗组与对照组各46例，两组均给予基础治疗，在此基础上对照组给予盐酸美西律片进行治疗，在对照组的基础上治疗组加用胺碘酮进行治疗。两组用药观察时间为15 d。两组治疗前后采用超声心动图进行左室收缩末期内径（LVDs）与左室舒张末期内径（LVDd）检测；治疗前后空腹抽取肘静脉血，分离血清后采用原子吸附法进行血清钾、镁离子检测。 结果 治疗组总有效率为86.9%，对照组总有效率为69.6%，两组总有效率差异有统计学意义（P<0.05）。两组治疗前后LVDs与LVDd差异无统计学意义（P>0.05），治疗后两组间比较差异无统计学意义（P>0.05）。治疗后治疗组的血清镁、钾离子浓度呈现明显增加的趋势，不过稳定在正常范围内，与治疗前比较，差异有统计学意义（P<0.05），与对照组治疗后比较，差异有统计学意义（P<0.05）。 结论 胺碘酮联合盐酸美西律治疗ICU高危快速型心律失常能有效改善预后，其疗效的发挥可能在于有效改善机体内钾离子通道。

[关键词] 高危快速型心律失常；盐酸美西律；胺碘酮

[中图分类号] R972[文献标识码] A[文章编号] 1674-4721（2014）06（c）-0063-03

Effect analysis of amiodarone combined with mexiletine hydrochloride in treatment of ICU high risk tachyarrhythmia

ZHENG Bin ZHOU Xu-hua

Intensive Care Unit,People′s Hospital of Xiangcheng County in Xuchang City of Henan Province,Xiangcheng 461700,China

[Abstract] Objective To investigate the effect of amiodarone combined with mexiletine hydrochloride in the treatment of ICU high risk tachyarrhythmia. Methods Ninety-two cases of patients with high risk tachyarrhythmia were evenly divided into treatment group and control group by randomly drawing lots.The basic treatment was provided in both groups.Besides,the mexiletine hydrochloride tablet was administered in the control group,amiodarone was added to the treatment group on the basis of the control group.The observation time for medication in both groups lasted 15 days.Before and after treatment,left ventricular end-systolic diameter (LVDs) and left ventricular diastolic diameter (LVDd) was detected by using echocardiographic;Cubital vein was exsanguinated,serum potassium and magnesium was detected by using atomic adsorption method. Results The total effective rate in the treatment group was 86.9%,while in the control group,it was 69.6%,there was statistical difference between two groups (P<0.05).The values of LVDs and LVDd before and after treatment in the two groups had no statistical differences (P>0.05),and there was no significant difference between the two groups after treatment (P>0.05).After treatment,the concentration of serum potassium and magnesium showed an obvious increasing tendency,but was still in the normal range,compared with before treatment,the difference was significant (P<0.05),and the difference between the two groups after treatment was significant (P<0.05). Conclusion amiodarone combined with mexiletine hydrochloride treating ICU high risk tachyarrhythmia can remarkably improve the prognosis,which might be related to the effective improvement of Potassium channel within the body.

[Key words] High risk tachyarrhythmia;Mexiletine hydrochloride;Amiodarone

心律失常是临床常见的心脏疾病，严重的心律失常有致命危险，也是心源性猝死的主要原因。高危快速型心律失常在发病前期可表现为无症状和症状轻微，然后出现晕厥、近似晕厥、心室颤动及心脏性猝死等并发症，为此需要进行ICU急诊治疗[1]。在当前的治疗中，不断开展的新技术新方法已经彻底改变了高危快速型心律失常的诊断和治疗观念[2]。有关高危快速型心律失常的基础研究已逐步倾向于分子、基因及离子通道的研究，并为药物联合治疗提供可靠的临床依据[3]。其……