摘要
目的探讨缬沙坦联合胺碘酮治疗慢性心力衰竭合并室性早搏的临床疗效及安全性。方法选择我院收治的84例慢性心力衰竭合并室性早搏患者为研究对象,采用随机数字表法随机分为观察组和对照组。对照组采用常规抗心衰配合胺碘酮治疗,观察组在对照组治疗的基础上加用缬沙坦治疗。分别于治疗前和治疗3个月后对两组患者24 h动态心电图变化、超声心动图改变及不良反应情况进行对比分析。结果治疗3个月后,两组患者心率均减慢,24 h室性早搏出现次数明显减少,差异均有统计学意义(P<0.01);而观察组心率明显慢于对照组,24 h室性早搏出现次数明显少于对照组,差异有统计学意义(P<0.01);观察组对室性早搏改善的有效率明显高于对照组(P<0.05)。观察组LA、LVEDV、LVESV均较治疗前明显缩小,LVEF明显增加,差异有统计学意义(P<0.01);对照组LA、LVEDV均较治疗前明显缩小,LVEF明显增加(P<0.01),LVESV虽缩小,但与治疗前差异无统计学意义(P>0.05);与对照组比较,观察组LA、LVEDV、LVESV及LVEF改变更为明显,差异有统计学意义(P<0.05)。观察组和对照组的不良反应发生率分别为31.0%和28.6%,两组比较差异无统计学意义(P>0.05)。结论在常规抗心衰治疗的基础上,应用缬沙坦、胺碘酮联合治疗心衰合并室性早搏,能从不同角度抑制AngⅡ的生成,起协同作用,明显提高了抗室性早搏效果和心脏功能,且并未增加治疗过程中不良反应的发生率,值得临床推广。
Objective To investigate the clinical efficacy and safety of valsartan combined with amiodarone in the treatment of chronic heart failure with ventricular premature beat. Methods 84 cases of chronic heart failure pa- tients with ventricular premature beat in our hospital were chosen, the patients were randomly divided into observation group and control group using the random number table method. Control group received conventional therapy for heart failure combined with arniodarone, observation group was added with valsartan. The 24 h dynamic electrocardiogram change, echocardiographic changes and adverse reactions of the two groups were compared before treatment and after 3 months of treatment. Results After 3 months of treatment, The heart rate of the two groups decreased （ P 〈 0. 01 ） ,24 h ventricular premature beat occurrences reduced（ P 〈 0. 01 ） ; compared with control group, the heart rate of observation group was obviously slower（ P 〈 0.01 ）, and the 24 h ventricular premature beat frequencies was significantly less （ P 〈 0. 01 ）. The effective rate of observation group in the improvement of ventricular premature beat was significantly higher than that of control group （ P 〈 0. 05 ）. The LA, LVEDV, LVESV of observation group decreased significantly （ P 〈 0.01 ） , LVEF increased obviously （ P 〈 0. 01 ）. The LA, LVEDV of control group became significantly narrowed （ P 〈 0. 01 ） ,LVEF increased obviously（ P 〈 0. 01 ）, but no significant difference was found in LVESV（ P 〉 0. 05 ）. Compared with control group, the LA, LVEDV, LVESV and LVEF changes of observation group were more apparent （P 〈 0.05 ）. The incidences of adverse reactions of observation group and control group were 31.0% and 28.6% ,there was no significant difference between the two groups （ P 〉 0. 05 ）. Conclusion On the basis of conventional treatment for heart failure, valsartan combined with amiodarone in the treatment of chronic heart failure with ventricular premature beat can suppress Ang II generating from different angles by synergic effect,it can significantly improve the effect on ventricular premature beat resistance and heart function, without increasing the incidence of adverse reaction, it is worthy of clinical promotion.
出处
《实用药物与临床》
CAS
2014年第2期147-150,共4页
Practical Pharmacy and Clinical Remedies
关键词
缬沙坦
胺碘酮
慢性心力衰竭
室性早搏
Valsartan
Amiodarone
Chronic heart failure
Ventricular premature beat
