【摘要】 目的分析厄贝沙坦联合胺碘酮在心力衰竭(心衰)合并心律失常患者中的治疗效果及对心功能的影响。方法选取2014年5月~2016年10月于上海市同仁医院接受治疗的心衰合并心律失常患者90例,男性39例,女性51例。随机分成观察组与对照组,各45例。对照组为常规治疗方式加服胺碘酮;观察组在对照组的基础上加服厄贝沙坦,疗程为6个月。治疗后评价两组疗效,并检测心电图,记录心率和QT离散度。在治疗前和治疗后超声心动图测定左室收缩末期内径(LVESD)、每搏心输出量(SV)、左室舒张末期内径(LVEDD)和左室射血分数(LVEF)。结果观察组总有效率为97.78%,对照组为80.00%,观察组明显高于对照组,差异有统计学意义(P<0.05)。与治疗前比较,两组治疗后SV、LVEF、LVESD和LVEDD均明显改善,差异有统计学意义(P均<0.05)。与对照组治疗后比较,观察组LVESD和LVEDD降低,而SV及LVEF升高,差异有统计学意义(P均<0.05)。经过6个月治疗,观察组患者QT离散度和心率均优于对照组,差异有统计学意义(P均<0.05)。结论厄贝沙坦联合胺碘酮治疗心衰合并心律失常患者效果显著,并且改善患者的心功能,值得在临床中推广使用。更多还原

【Abstract】 Objective To analyze the therapeutic effect and influence on heart function of irbesartan combined with amiodarone in patients with heart failure complicated by arrhythmia. Methods The patients(n=90, male 39 and female 51) were chosen from the Tong Ren Hospital of Shanghai City from May 2014 to Oct. 2016, and divided randomly into observation group and control group(each n=45). The control group was given routine therapy and amiodarone, and observation group was additionally given irbesartan for 6 months. The curative effect was reviewed, electrocardiogram(ECG) was detected, and heart rate(HR) and QT interval dispersion(QTd) were recorded in 2 groups after treatment. The left ventricular end-systolic diameter(LVESD), stroke volume(SV), left ventricular end-diastolic inner diameter(LVEDD) and left ventricular ejection fraction(LVEF) were detected by using echocardiogram before and after treatment. Results The total effective rate was 97.78% in observation group and 80.00% in control group(P<0.05). SV, LVEF, LVESD and LVEDD were significantly improved in 2 groups after treatment(all P<0.05). LVESD and LVEDD decreased and SV and LVEF increased in observation group compared with control group after treatment(all P<0.05). After treatment for 6 months, QTd and HR were all superior in observation group to those in control group(all P<0.05). Conclusion Irbesartan combined with amiodarone has significant efficacy and can improve heart function in patients with heart failure complicated by arrhythmia, which is well worth clinical application.更多还原