胺碘酮对慢性充血性心力衰竭并室性心律失常的疗效及QT离散度的影响

Effect of amiodarone on therapeutic efficacy and QT dispersion with chronic congestive heart failure and ventricular arrhythmia

目的观察胺碘酮对慢性充血性心力衰竭（CCHF）并室性心律失常的疗效及QT离散度的影响。方法42例CCHF并室性心律失常患者常规治疗心力衰竭的同时，给予口服胺碘酮治疗8周，观察其疗效及治疗前后（校正）OT离散度（QTcd）的变化。结果观察组患者治疗前的QTcd显著大于正常对照组（F5．6767．P〈0．01）。治疗8周后观察组控制室性心律失常的总有效率为90．5％；观察组患者治疗后的心率、LVESV、QTcd显著低于治疗前（t=11．698、2．5248、3．1841，P〈0．01或P〈0．05），LVEF显著高于治疗前（沪2．5780，P〈0．05）；观察组患者治疗后的QTcd仍显著高于正常对照组（t=2．7499，P〈0．01）。结论胺碘酮能改善慢性充血性心力衰竭患者的心功能，降低QTcd，减少室性心律失常，可安全用于治疗慢性充血性心力衰竭并室性心律失常。

Objective To observe the effects of amiodarone on therapeutic effect and QT dispersion with chronic congestive heart failure and ventricular arrhythmia. Methods 42 patients with chronic congestive heart failure and ventricular arrhythmia were treated with amiodarone therapy for 8 weeks based on the conventional treatment of heart failure. The efficacy and （corrected） QT dispersion （QTcd） changes before and after treatment were observed. Results The QTcd of the observation group was significantly greater than the normal control group before treatment （t=5.6767, P〈0.01 ）. The total effective of control arrhythmia in the observation group was 90.5% after 8 weeks treatment. The heart rate, LVESV, QTcd in the observation group after treatment were significantly lower than before treatment （t= 11.698,2.5248,3.1841, P〈0.01 or P〈0.05 ）, LVEF in the observation group after treatment was significantly higher than before treatment （t=2.5780, P〈0.05 ）, QTcd in the observation group after treatment was still significantly higher than the normal control group （t=2.7499, P〈0.01 ）. Conclusion Amiodarone can improve heart failure patients with chronic congestive heart function and reduce QTcd, reduce ventricular arrhythmias, safe for the treatment of chronic congestive heart failure and ventricular arrhythmias.