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胺碘酮在预防冠状动脉旁路移植术后房颤中的作用研究 |
韩庆奇,沈美芳,徐志云,张宝仁,黄盛东,邹良建,徐激斌,韩林,赵铁军,何斌 |
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(第二军医大学长海医院胸心外科,上海,200433) |
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摘要: |
目的:评价胺碘酮在预防冠状动脉旁路移植(CABG)术后房颤(AF)中的作用.方法:184例行常规体外循环(CPB)下CABG患者随机分成实验组和对照组,每组内部又分成60岁以下组和60岁及以上组,实验组术后给予常规药物+胺碘酮,对照组术后给予常规药物+安慰剂.结果:对照组术后AF总发生率明显高于实验组(32.2﹪vs6.4﹪,P<0.01,OR=7.0).对于60岁以下组,实验组和对照组之间术后AF的发生率无统计学意义,而对于60岁及以上组则存在统计学意义(P<0.05,P<0.01).实验组内部60岁以下组和60岁及以上组之间的AF发生率无统计学意义,而对照组内部60岁以下组和60岁及以上组之间的AF发生率则存在统计学意义(P<0.05,P<0.01).结论:胺碘酮可以有效预防CABG术后房颤的发生,尤其对于60岁及以上的患者效果更加明显.我们推荐对于60岁及以上的患者,CABG术后应积极应用胺碘酮预防AF的发生. |
关键词: 胺碘酮、冠状动脉旁路移植、心房颤动 |
DOI:10.3724/SP.J.1008.2006.00973 |
投稿时间:2006-01-30修订日期:2006-06-23 |
基金项目: |
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Amiodarone in prevention of atrial fibrillation after coronary artery bypass grafting |
HAN Qing-qi,SHEN Mei-fang,XU Zhi-yun,ZHANG Bao-ren,HUANG Sheng-dong,ZOU Liang-jian,XU Ji-bin,HAN Lin,ZHAO Tie-jun,HE Bin |
(第二军医大学长海医院胸心外科,上海,200433) |
Abstract: |
Objeetive : To evaluate the role of amiodarone in preventing atrial fibrillation after coronary artery bypass grafting (CABG). Methods: Totally 184 patients receiving CABG under cardiopulmonary bypass (CPB) were randomly divided into amiodarone group (n= 94) and placebo group (n= 90), and patients in each group were further divided into ≥ 60 years and 60 years subgroups. Patients in amiodarone group received routine drugs + amiodarone and those in placebo group received routine drugs + placebo. Results: The overall incidence of postoperative AF (paroxysmal and persistent) was significantly higher in the placebo group compared with the amiodarone group (32.20% vs 6.4%, P〈0.01, OR=7.0). The incidences of postoperative AF were similar in patients aged 〈60 years between the placebo group and the amiodarone group, but were significantly different in patients aged ≥ 60 (P〈0. 05 or P〈0.01). The postoperative AF incidence was significantly different between 2 age subgroups (P〈0. 05 or P〈0.01) in the placebo group, but not in amiodarone group. Conclusion: Amiodarone can effectively prevent post-operative AF, especially for patients aged ≥ 60 years. Amiodarone should be recommended to patients re- ceiving CABG who aged ≥ 60 years |
Key words: amiodarone coronary artery bypass atrial fibrillation |