胺碘酮联合厄贝沙坦对心力衰竭合并心律失常的疗效及机制研究(1)
【摘要】 目的 觀察胺碘酮联合厄贝沙坦对心力衰竭合并心律失常的临床疗效， 探讨其作用机制。方法 91例心力衰竭合并心律失常患者作为研究对象， 以随机分组的方式分为观察组(46例)和对照组(45例)。对照组使用常规治疗联合胺碘酮， 观察组在对照组基础上加用厄贝沙坦， 对比两组窦性心律维持率及治疗效果。结果 观察组总有效率93.48%明显高于对照组的77.78%， 差异具有统计学意义(P<0.05)。观察组治疗后第1、3、5个月的窦性心律维持率67.39%、82.61%、63.04%均高于对照组的42.22%、60.00%、40.00%， 差异具有统计学意义(P<0.05)。治疗前两组心输出量(CO)、左室射血分数(LVEF)、左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD)比较差异无统计学意义(P>0.05)；治疗后两组CO、LVEF、LVESD、LVEDD均优于治疗前， 且观察组明显优于对照组， 差异具有统计学意义(P<0.05)。观察组不良反应发生率17.39%低于对照组的35.56%， 差异具有统计学意义(P<0.05)。
结论 在治疗心力衰竭合并心律失常中应用胺碘酮联合厄贝沙坦比单一方式效果更好， 可有效改善患者窦性心律维持率， 值得临床推广应用。
【关键词】 胺碘酮；厄贝沙坦；心力衰竭合并心律失常；疗效
DOI：10.14163/j.cnki.11-5547/r.2018.01.050
【Abstract】 Objective To observe the clinical efficacy of amiodarone combined with irbesartan on heart failure complicated with arrhythmia， and discuss its mechanism of action. Methods A total of 91 heart failure complicated with arrhythmia patients as study subjects were divided by random grouping method into observation group (46 cases) and control group (45 cases). The control group received conventional therapy and amiodarone， and the observation group received irbesartan on the basis of the control group. Comparison were made on sinus rhythm maintenance rate and treatment effect between two groups. Results The observation group had obviously higher total effective rate as 93.48% than 77.78% in the control group， and the difference was statistically significant (P<0.05). The observation group had higher sinus rhythm maintenance rate after 1， 3 and 5 months of treatment as 67.39%， 82.61% and 63.04% than 42.22%， 60.00% and 40.00% in the control group， and their difference was statistically significant (P<0.05). Before treatment， both groups had no statistically significant difference in cardiac output (CO)， left ventricular ejection fraction (LVEF)， left ventricular end systolic diameter (LVESD)， left ventricular end-diastolic dimension (LVEDD) (P>0.05). After treatment， both groups had better CO， LVEF， LVESD and LVEDD than the control group， and the difference was statistically significant (P<0.05). The observation group had lower incidence of adverse reactions as 17.39% than 35.56% in the control group， and the difference was statistically significant (P<0.05). Conclusion Application of amiodarone and irbesartan shows better effect than simple irbesartan， and can effectively improve sinus rhythm maintenance rate. It is worthy of clinical promotion and application.
【Key words】 Amiodarone； Irbesartan； Heart failure complicated with arrhythmia； Efficacy, 百拇医药(覃启高)
结论 在治疗心力衰竭合并心律失常中应用胺碘酮联合厄贝沙坦比单一方式效果更好， 可有效改善患者窦性心律维持率， 值得临床推广应用。
【关键词】 胺碘酮；厄贝沙坦；心力衰竭合并心律失常；疗效
DOI：10.14163/j.cnki.11-5547/r.2018.01.050
【Abstract】 Objective To observe the clinical efficacy of amiodarone combined with irbesartan on heart failure complicated with arrhythmia， and discuss its mechanism of action. Methods A total of 91 heart failure complicated with arrhythmia patients as study subjects were divided by random grouping method into observation group (46 cases) and control group (45 cases). The control group received conventional therapy and amiodarone， and the observation group received irbesartan on the basis of the control group. Comparison were made on sinus rhythm maintenance rate and treatment effect between two groups. Results The observation group had obviously higher total effective rate as 93.48% than 77.78% in the control group， and the difference was statistically significant (P<0.05). The observation group had higher sinus rhythm maintenance rate after 1， 3 and 5 months of treatment as 67.39%， 82.61% and 63.04% than 42.22%， 60.00% and 40.00% in the control group， and their difference was statistically significant (P<0.05). Before treatment， both groups had no statistically significant difference in cardiac output (CO)， left ventricular ejection fraction (LVEF)， left ventricular end systolic diameter (LVESD)， left ventricular end-diastolic dimension (LVEDD) (P>0.05). After treatment， both groups had better CO， LVEF， LVESD and LVEDD than the control group， and the difference was statistically significant (P<0.05). The observation group had lower incidence of adverse reactions as 17.39% than 35.56% in the control group， and the difference was statistically significant (P<0.05). Conclusion Application of amiodarone and irbesartan shows better effect than simple irbesartan， and can effectively improve sinus rhythm maintenance rate. It is worthy of clinical promotion and application.
【Key words】 Amiodarone； Irbesartan； Heart failure complicated with arrhythmia； Efficacy, 百拇医药(覃启高)