胺碘酮对心律失常患者心功能、心率变异性及血清炎性因子水平的影响

Effects of amiodarone on cardiac function, heart rate variability and serum inflammatory factor levels in patients with arrhythmia

目的观察胺碘酮对心律失常患者心功能、心率变异性及血清炎性因子水平的影响。方法将我院收治的心律失常患者105例,按随机数字表法分为试验组(n=53)和对照组(n=52)。对照组给予普罗帕酮(第1周,每次150 mg,每天3次;第2周及以后,每次100 mg,每天3次);试验组在对照组治疗的基础上,给予胺碘酮(第1周,每次0.2 g,每天3次;第2周及以后,每次0.2 g,每天2次)。2组均连续治疗3个月。比较2组患者的临床疗效;检测2组治疗前后心功能、心率变异性指标及炎性因子水平。结果治疗后,试验组和对照组临床总有效率分别为90.57%(48例/53例)和82.69%(43例/52例),差异有统计学意义(P<0.05)。治疗后,对照组与试验组血清白细胞介素-6(IL-6)水平分别为(24.29±2.86)和(15.96±1.78)ng·mL-1,超敏C反应蛋白(hs-CRP)水平分别为(11.63±2.81)和(7.23±2.34)mg·L-1,差异均有统计学意义(均P<0.05)。与治疗前相比,治疗后2组每搏输出量(SV)、左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)差异均有统计学意义,且试验组与对照组相比,差异均有统计学意义(均P<0.05)。与治疗前比,治疗后2组窦性RR期间的标准差(SDNN)、相邻RR间期差值的均方根(RMSSD)、24 h内每5 min正常RR间期标准差的平均值(SDNN index)及每5 min窦性RR间期均值的标准差(SDANN)指标水平升高,且试验组高于对照组(P<0.05)。结论胺碘酮可改善心律失常患者心功能及心率变异性,减轻炎性反应,且临床效果显著优于普罗帕酮。

Objective To investigate the effects of amiodarone on cardiac function, heart rate variability and serum inflammatory factor levels in patients with arrhythmia.Methods A total of 105 patients with arrhythmia treated in our hospital were divided into treatment group(n=53) and control group(n=52) according to the random number table method.Control group was given propafenone(150 mg·time-1 in the first week, 3 times·d-1;100 mg ·time-1 in the second week and later, 3 times ·d-1) treatment, treatment group was given amiodarone(0.2 g·time-1 in the first week, 3 times ·d-1;0.2 g·time-1 in the second week and later, 2 times·d-1) on the basis of control group.Two groups were treated continuously for 3 months.The clinical efficacy after treatment in 2 groups were observed;the cardiac function, heart rate variability index and serum inflammatory factor levels in 2 groups were detected before and after treatment.Results The total effective rate was 90.57%(48 cases/53 cases) in treatment group after treatment,which was significantly higher than that 82.69%(43 cases/52 cases) in control group(P < 0.05).The serum interleukin-6(IL-6)levels in control group and treatment group after treatment were(24.29±2.86),(15.96±1.78) ng·mL-1,hs-CRP levels were(11.63±2.81),(7.23±2.34) mg·L-1,with significant difference(P<0.05).Compared with before treatment,the stroke output(SV),left ventricular ejection fraction(LVEF) levels in two groups significantly increased after treatment,treatment group was significantly higher than control group,the left ventricular end-diastolic diameter(LVEDD) levels in two groups were significantly decreased after treatment,treatment group was significantly lower than control group(P<0.05).Compared with before treatment,the standard diviation of NN intervals(SDNN),the square root of the mean of the squared differences between adjacent normal RR intervals(RMSSD),SDNN index,standard deviation of the average R-R intervals calculated every five minutes(SDANN) levels in two groups were significantly increased after treatment,and treatment group was significantly higher than control group(P<0.05).Conclusion Amiodarone can significantly improve the cardiac function and heart rate variability of patients with arrhythmia,reduce the inflammatory response,and the clinical effect is significantly better than that of propanone treatment.