張玉柱

[摘要] 目的 探討急診中治療冠心病性快速心律失常采用門冬氨酸鉀鎂和胺碘酮的臨床效果，并比較患者的用藥安全性。方法 方便選擇該院2015年3月—2017年8月期間收治的84例冠心病性快速心律失常患者作為該次研究病例，對(duì)患者進(jìn)行分組，分組方式為計(jì)算機(jī)表法分為研究組與對(duì)照組，各42例，對(duì)照組患者應(yīng)用胺碘酮治療，研究組患者采取胺碘酮聯(lián)合門冬氨酸鉀鎂治療，對(duì)比分析兩組的治療效果，比較兩組的心率與心電圖監(jiān)測(cè)結(jié)果、不良反應(yīng)。 結(jié)果 室性早搏有效率最高（62.07%），其次為陣發(fā)性房顫（47.62%）、持續(xù)性房顫（20.00%）、陣發(fā)性室上心動(dòng)過速（16.66%）、竇性心動(dòng)過速（14.28%）;研究組治療后心電圖所示的心率、QT間期、PR間期[（76.3±2.5）次/min、（152.1±6.0）ms、（39.6±1.2）ms]顯著優(yōu)于對(duì)照組[（94.2±3.0）次/min、（144.5±5.4）ms、（37.1±2.0）ms]，組間比較差異有統(tǒng)計(jì)學(xué)意義（t=29.705 9、6.101 6、6.946 4，P=0.000 0、0.000 0、0.000 0<0.05）;對(duì)照組不良反應(yīng)發(fā)生率為13.95%，研究組不良反應(yīng)發(fā)生率為4.65%，組間比較差異無統(tǒng)計(jì)學(xué)意義（χ2=2.210 5，P=0.137 0>0.05），患者不良反應(yīng)經(jīng)針對(duì)性治療后均得到改善或消失。結(jié)論 門冬氨酸鉀鎂與胺碘酮治療冠心病性快速心律失常的效果明顯，能夠有效改善患者的臨床癥狀，緩解患者室性早搏與陣發(fā)性房顫等癥狀，值得臨床應(yīng)用探索。

[關(guān)鍵詞] 急診;門冬氨酸鉀鎂;胺碘酮;冠心病;快速心律失常

[中圖分類號(hào)] R541.4? ? ? ? ? [文獻(xiàn)標(biāo)識(shí)碼] A? ? ? ? ? [文章編號(hào)] 1674-0742（2019）05（a）-0103-03

[Abstract] Objective To investigate the clinical effect of potassium magnesium aspartic acid and amiodarone in the emergency treatment of coronary arrhythmia， and to compare the safety of the patients. Methods A total of 84 patients with coronary heart disease rapid arrhythmia admitted to our hospital from March 2015 to August 2017 were convenient selected. By the method of computer tables， they were divided into study group and control group. Forty-two cases in the control group patients applied amiodarone treatment， and forty-two patients in the study group took amiodarone combined nmda potassium magnesium treatment. Treatment effect， the heart rate， electrocardiogram monitoring results and adverse reactions of the two groups were compared. Results The effective rate of ventricular premature heartbeat was the highest （62.07%）， followed by paroxysmal af （47.62%）， persistent af （20.00%）， paroxysmal supraventricular tachycardia （16.66%） and sinus tachycardia （14.28%）. The heart rate， QT interval and PR interval [（76.3±2.5）min，（152.1±6.0）ms，（39.6±1.2）ms] of the study group after treatment were significantly better than those of the control group[（94.2±3.0）min，（144.5±5.4）ms，（37.1±2.0）min]， and the comparison between the two groups was statistically significant （t=29.705 9， 6.101 6， 6.946 4， P=0.000 0， 0.000 0， 0.000 0<0.05）. The incidence of adverse reactions was 13.95% in the control group and 4.65% in the study group， with no statistical significance （χ2=2.210 5， P=0.137 0>0.05）. All adverse reactions were improved or disappeared after targeted treatment. Conclusion The effect of potassium magnesium aspartic acid and amiodarone in the treatment of coronary heart disease rapid arrhythmia is obvious， which can effectively improve the clinical symptoms of patients， alleviate the symptoms of patients with premature ventricular beat and paroxysmal atrial fibrillation， and is worth clinical application and exploration.