目的评价胺碘酮联合稳心颗粒与胺碘酮治疗急性心肌梗死(AMI)并室性心律失常的疗效和安全性。方法 204例AMI患者完全随机分为胺碘酮联合稳心颗粒组和胺碘酮组,每组102例。所有患者均按AMI常规处理,胺碘酮组予胺碘酮首剂150mg+0.9%氯化钠溶液20ml,10min内注入,间隔10～15min可重复,随后以1.0～1.5mg/min滴注维持6h,之后依病情减少剂量至0.5mg/min,直至仅出现偶发室性早搏,停止静脉给药,改口服胺碘酮600mg/d连续7d,此后改400mg/d连续7d,最后改为200mg/d维持治疗1个月,再减至200mg,1次/d,每周5d,间歇2d,维持6个月。胺碘酮联合稳心颗粒组在胺碘酮组治疗的基础上加服稳心颗粒,1袋(9g)/次,3次/d,维持6个月。结果胺碘酮联合稳心颗粒组,显效40例(39.2%),有效48例(47.1%),总有效率86.3%;胺碘酮组患者显效30例(29.9%),有效44例(43.1%),总有效率72.5%。2组差异有统计学意义(P<0.05)。无恶化病例,未出现严重不良反应。随访6个月未出现甲状腺功能异常及严重心律失常的发生。结论胺碘酮和稳心颗粒联合治疗AMI后室性心律失常效果满意,安全可靠,值得临床推广使用。

AIM:To study the correlation of liver function and red blood cell parameters with repeat drinking in alcohol-dependent patients. METHODS:Three hundred and twelve alcohol-dependent patients and 40 normal subjects were selected and compared in this study. The inves-tigation included general state of health as well as liver function and red blood cell parameters. The correlation of liver function and red blood cell parameters with alcohol consumption and drinking time was then analyzed. RESULTS:Compared with normal controls,alanine transaminase (ALT),aspartate transaminase (AST),gamma-glutamyl transpeptidase (GGT),cholylglycine (CG),mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH) rose signifi cantly,and hematocrit declined significantly in alcohol-dependent patients (all P < 0.001). The changes in these parameters are correlated with alcohol consumption and drinking time (r = 0.61 and 0.59,respectively; both P < 0.01). CONCLUSION:Repeat drinking may result in abnormal liver function and red blood cell parameters in alcohol-dependent patients. Dynamic monitoring of GGT,ALT and AST is conducive to the diagnosis of alcoholic liver disease. MCV can be used as a parameter for evaluation of dangerous alcohol drinking.

本文综述了溶血的原因及对策,体内外溶血的鉴别,溶血对生化结果的影响及机制,溶血标本的处理和评价。