胺碘酮治疗充血性心力衰竭合并室性心律失常的临床研究(1)
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【摘要】目的:探讨胺碘酮治疗充血性心力衰竭合并室性心律失常的临床疗效与安全性。方法:116例充血性心力衰竭合并室性心律失常患者随机分为观察组66例和对照组50例。对照组予以常规抗心衰治疗,观察组在对照组的基础上口服盐酸胺碘酮片,第1周200 mg、tid;第2周200 mg、bid;第3周及以后200 mg、qd,规律服药12周。观察患者的临床症状、心电图或进行24 h动态心电图检查,观察心律失常的变化,监测药物不良反应。结果治疗后,观察组抗心律失常有效率明显优于对照组(P<0.01),观察组心源性猝死率低于对照组(P<0.05),观察组LEVF改善程度略高于对照组,但差异不具有统计学意义(P>0.05)。结论在常规充血性心力衰竭治疗的基础上,小剂量胺碘酮对充血性心力衰竭合并室性心律失常具有良好的临床疗效,包括改善心功能、抗室性心律失常,降低心源性猝死,延长患者生命,改善其生活质量等,且具有良好的安全耐受性,可作为充血性心力衰竭合并室性心律失常治疗的推荐方案之一,值得临床推广应用。
【关键词】胺碘酮;充血性心力衰竭;室性心律失常;心源性猝死;左室射血分数
Clinical Research on Treating Congestive Heart Failure with Ventricular Arrhythmia by Amiodarone
GuDonghua
【Abstract】ObjectivesTo explore the clinical efficacy and safety of treating congestive heart failure with ventricular arrhythmia by amiodarone. Methods 116 patients of CHF with ventricular arrhythmia were randomly divided into observation group and control group, and 66 cases in observation group, 50 cases in control group. Control group were given CHF's conventional therapy, yet observation group were given amiodarone on the basis of CHF's conventional therapy. Dose of amiodarone as follows: 200mg, three times per day in the first week, then 200mg, twice per day in the second week, and 200mg, once per day in the third week and following weeks. All patients were regularly treated for 12 weeks. Observing patients' clinical symptoms, ECG or 24 h Holter, changes of arrhythmia, and monitoring adverse reactions. ResultsAfter treatment, observation group's efficiency of treating ventricular arrhythmia was obviously better than control group's(P<0.01), observation group's sudden cardiac death rate was lower than control group's(P<0.05), and observation group's LEVF improvement degree was slightly higher than observation group's, but the difference was not statistically significant(P>0.05). ConclusionOn the basis of CHF's conventional therapy, low-dose amiodarone had favorable efficacy to CHF with ventricular arrhythmia, including improving cardiac function, anti-arrhythmia, reducing sudden cardiac death, extending patients' life and improving their life quality, also fewer adverse reactions, so it can be one of recommended options of treating CHF with ventricular arrhythmia, and it is worthy of clinical application ......
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