胺碘酮治疗56例慢性心力衰竭合并室性心律失常的临床疗效分析

Clinical Effectiveness Analysis of Amiodarone in the Treatment of 56 Cases of Patients with Chronic Heart Failure Complicated by Ventricular Arrhythmias

目的：观察分析口服胺碘酮治疗慢性心力衰竭合并室性心律失常的临床疗效。方法：入选病例按照慢性心力衰竭常规治疗后,给予口服胺碘酮0.2g Tid,一周后剂量调整为0.2g Bid,第二周根据临床疗效调整为0.1~0.2g Qd,再维持6周。治疗期间严密监测患者血压、心电图、肝肾功能、肺功能、X线胸片及电解质情况等。结果：治疗后显效21例（37.5%）,有效27例（48.2%）,总有效率85.7%。治疗8周后,血压有所下降,但二者相比无统计学意义（P〉0.05）;LVEF、LVDd均有明显改善（P〈0.01）。心电图变化可见治疗后心率降低（P〈0.01）,QT间期延长（P〈0.05）,而QRS间期、QTc间期和QTd间期治疗前后变化不大（P〉0.05）。结论：胺碘酮常规治疗剂量和维持量用于慢性心力衰竭合并室性心律失常是安全有效的。

Objective：To observe the clinical effectiveness of oral amiodarone in the treatment of chronic heart failure complicated by ventricular arrhythmia .Methods：After accordance with the conventional treatment of chronic heart failure, selected cases were given oral amiodarone 0.2g Tid;a week later the dose was adjusted to 0.2g Bid;The next week the dose was adjusted to 0.1~0.2g Qd according to the clinical effectiveness for 6 weeks;The blood pressure, ECG, Liver and kidney function ,pulmonary function, X–ray, electrolytes of patients were closely monitored during treatment period .Results：After the treatment, the total effective rate for VA was 85.7%, including obvious effective rate 37.5%, and effective rate 42.8%. There was some decrease of the blood pressure after 8 weeks. The two groups had no significant difference compared with each other （P〉0.05）. LVEF and LVDd were significant improved（P〈0.01）. There was significant decrease of the heart rate （P〈0.01）and a slight prolongation of Q-T internal（P〈0.05）in the ECG. There were little change in QRS internal QTc internal and QTd internal between before and after treatment （P〉0.05）. Conclusion：It is safe and effective for amiodarone conventional treatment dose and maintenance dose in the treatment of chronic heart failure complicated by ventricular arrhythmias.