门冬氨酸钾镁联合胺碘酮对慢性心力衰竭合并心律失常患者心功能、血液流变学和炎性因子的影响

Effect of potassium aspartate magnesium combined with amiodarone on cardiac function,hemorheology and inflammatory factors in patients with chronic heart failure and arrhythmia

目的观察门冬氨酸钾镁联合胺碘酮治疗慢性心力衰竭合并心律失常对患者心功能、血液流变学、血清炎性因子的影响。方法选取2015年3月—2016年4月解放军第九七医院心血管内科诊治慢性心力衰竭合并心律失常患者98例作为研究对象,按随机数字表法分为观察组(n=50)和对照组(n=48)。对照组给予门冬氨酸钾镁治疗,观察组给予门冬氨酸钾镁联合胺碘酮治疗。比较治疗后临床效果、心功能、血液流变学、炎性因子、不良反应。结果治疗后,观察组总有效率为94. 00%,高于对照组的75. 00%(χ~2=6. 819,P=0. 009);治疗后,2组LVEDD、LVPWD低于治疗前,LVEF高于治疗前,且观察组变化幅度大于对照组(t=6. 881、7. 785、5. 874,P均=0. 000); 2组患者低切黏度、高切黏度、血浆比黏度、纤维蛋白原表达水平均低于治疗前(P <0. 01),且观察组低于对照组(t=5. 108、5. 760、5. 588、5. 874,P均=0. 000);治疗后,2组患者血清IL-6、IL-8、TNF-α等炎性因子表达水平均低于治疗前(P <0. 01),且观察组低于对照组(t=2. 482、7. 115、4. 970,P均=0. 000)。治疗期间,2组患者均有出现恶心、呕吐、低血压、肝功能损伤、心动过缓等不良反应,但观察组总发生率为10. 00%,明显低于对照组的29. 17%(χ~2=5. 756,P=0. 016)。结论门冬氨酸钾镁联合胺碘酮治疗慢性心力衰竭合并心律失常患者,可改善患者心功能、血液流变学,抑制炎性因子释放,降低不良反应发生率,效果显著,值得临床推广使用。

Objective To observe the effect of Potassium Aspartate magnesium combined with amiodarone on cardiac function, hemorheology and inflammatory factors in patients with chronic heart failure and arrhythmia. Methods Ninety-eight patients with chronic heart failure and arrhythmia were selected as the subjects in the cardiovascular medicine department of the 97 Hospital of Chinese people＇s Liberation Army from 2015 March to 2016 April. According to the different treatment methods, the patients were divided into the observation group （ n =50） and the control group （ n =48）. The control group was treated with Potassium Aspartate magnesium, while the observation group was treated with Potassium Aspartate magnesium combined with amiodarone. The clinical effects, cardiac function, inflammatory factors, hemorheology and adverse reactions were compared. Results After treatment, the total effective rate of the observation group was 94.00%, which higher than that of the control group （75.00%） （χ^2=6.819, P =0.009,）. After the treatment, the 2 groups’ LVD and LVWD were lower than before and before the treatment, and the changes in the observation group were greater than those of the control group （ t = 6.881, t =7.785, t =5.874,all P =0.000）; the 2 groups with lower shear viscosity, higher shear viscosity, and plasma viscosity compared to before treatment. The expression level of fibrinogen was lower than that before treatment （ P 〈0.05）, and the observation group was lower than the control group （ t =5.108, t =5.760, t =5.588, t =5.874,all P =0.000）. After treatment, the expressions of inflammatory factors such as IL-6, IL-8 and TNF-α were lower than those before the treatment （ P 〈 0.05 ）, and the observation group was lower than the control group （ t =2.482, t =7.115, t =4.970, all P =0.000）.During the treatment, the 2 groups had adverse reactions such as nausea, vomiting, hypotension, liver injury, and bradycardia, but the total incidence of the observation group was 10.00% lower than that of the control group of 29.17% （χ^2=576, P = 0.016）. Conclusion The treatment of Potassium Aspartate magnesium combined with amiodarone in patients with chronic heart failure and arrhythmia can improve cardiac function, hemorrheology, inhibit the release of inflammatory factors and reduce the incidence of adverse reactions. It is worthy of clinical application.