短时间胺碘酮与去乙酰毛花苷联合治疗甲状腺功能亢进性心脏病心力衰竭合并快心室率心房颤动的疗效观察

Efficacy of Amiodarone Combined with Deslanoside in Short Time in Treatment of Hyperthyroid Cardiopathy with Heart Failure and Atrial Fibrillation with Fast Ventricular Rate

目的:探讨短时间胺碘酮与去乙酰毛花苷联合治疗甲状腺功能亢进性心脏病心力衰竭合并快心室率心房颤动的临床疗效。方法:选取206例甲状腺功能亢进性心脏病心力衰竭合并快心室率心房颤动患者,以随机数字表法分为观察组和对照组各103例。观察组患者给予短时间胺碘酮与去乙酰毛花苷联合治疗;对照组患者则单纯给予去乙酰毛花苷治疗。对比观察2组患者病情变化、心功能分级情况及出院后的甲状腺功能指标等。结果:治疗3 d,观察组患者心房颤动复律率为26.21%(27/103),明显高于对照组的14.56%(15/103),差异有统计学意义(P<0.05)。观察组患者心房颤动复律时间为(213.5±38.6)min、心率为(84.3±13.6)次/min、转入重症监护病房3例,均明显优于对照组的(233.8±50.2)min、(91.2±14.5)次/min、11例,差异均有统计学意义(P<0.05)。治疗5 d,观察组患者的心功能分级(纽约心脏病协会分级)明显优于对照组,差异有统计学意义(P<0.05)。出院3个月及6个月后,2组患者甲状腺功能各项指标的差异无统计学意义(P>0.05)。结论:短时间内使用胺碘酮与去乙酰毛花苷联合治疗甲状腺功能亢进性心脏病心力衰竭合并快心室率心房颤动,临床效果显著,能有效缓解心律失常,提高心房颤动复律率,值得临床推广。

OBJECTIVE： To probe into the clinical efficacy of amiodarone combined with deslanoside in short timein treatment of hyperthyroid cardiopathy with heart failure and atrial fibrillation with fast ventricular rate. METHODS：206 patients of hyperthyroid cardiopathy with heart failure and atrial fibrillation with fast ventricular rate were selected to be divided into the observation group and control group according to the random number table,with 103 cases in each group. The observation group received amiodarone combined with deslanoside treatment in a short period of time,and the control group were only treated with deslanoside. The changes of disease,classification of heart function and post-discharge indexes of thyroid function were observed and compared between two groups. RESULTS： After treatment of 3d,the cardioversion rate of atrial fibrillation was 26. 21%（ 27 /103）,significantly higher than that in control group[14. 56%（ 15 /103） ],with statistically significant difference（ P 0. 05）. In observation group,the cardioversion time was（ 213. 5 ± 38. 6） min,heart rate was（ 84. 3 ± 13. 6） times / min and 3 cases of patients had been transferred into ICU,all of which were significantly better than that in control group：（ 233. 8 ± 50. 2） min、（ 91. 2 ± 14. 5） times /min、11 cases,respectively; there were significant differences in two groups（ P 0. 05）. After treatment of 5 d,NYHA classification in observation group was significantly better than that in control group,with statistically significant difference（ P 0. 05）. After discharge of 3 months and 6 months,there were no significant difference in the indexes of thyroid function between two groups of patients（ P 0. 05）. CONCLUSIONS： The clinic efficacy of amiodarone combined with deslanoside in short time in treatment of hyperthyroid cardiopathy with heart failure and atrial fibrillation with fast ventricular rate is significant,and can effectively alleviate the arrhythmia,improve the cardioversion rate of atrial fibrillation. It is worthy of clinic promotion.