急诊应用门冬氨酸钾镁和胺碘酮治疗冠心病性快速心律失常的效果评价

张玉柱

[摘要] 目的 探討急诊中治疗冠心病性快速心律失常采用门冬氨酸钾镁和胺碘酮的临床效果，并比较患者的用药安全性。方法 方便选择该院2015年3月—2017年8月期间收治的84例冠心病性快速心律失常患者作为该次研究病例，对患者进行分组，分组方式为计算机表法分为研究组与对照组，各42例，对照组患者应用胺碘酮治疗，研究组患者采取胺碘酮联合门冬氨酸钾镁治疗，对比分析两组的治疗效果，比较两组的心率与心电图监测结果、不良反应。 结果 室性早搏有效率最高（62.07%），其次为阵发性房颤（47.62%）、持续性房颤（20.00%）、阵发性室上心动过速（16.66%）、窦性心动过速（14.28%）;研究组治疗后心电图所示的心率、QT间期、PR间期[（76.3±2.5）次/min、（152.1±6.0）ms、（39.6±1.2）ms]显著优于对照组[（94.2±3.0）次/min、（144.5±5.4）ms、（37.1±2.0）ms]，组间比较差异有统计学意义（t=29.705 9、6.101 6、6.946 4，P=0.000 0、0.000 0、0.000 0<0.05）;对照组不良反应发生率为13.95%，研究组不良反应发生率为4.65%，组间比较差异无统计学意义（χ2=2.210 5，P=0.137 0>0.05），患者不良反应经针对性治疗后均得到改善或消失。结论 门冬氨酸钾镁与胺碘酮治疗冠心病性快速心律失常的效果明显，能够有效改善患者的临床症状，缓解患者室性早搏与阵发性房颤等症状，值得临床应用探索。

[关键词] 急诊;门冬氨酸钾镁;胺碘酮;冠心病;快速心律失常

[中图分类号] R541.4          [文献标识码] A          [文章编号] 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.