西地兰联合胺碘酮治疗急诊重症心衰合并快速性心律失常患者的临床效果分析

Clinical effect analysis of cedilanid combined with amiodarone in the treatment of emergency department of patients with severe heart failure and tachyarrhythmia

目的探析西地兰联合胺碘酮治疗急诊重症心衰合并快速性心律失常患者的临床效果。方法60例急诊重症心衰合并快速性心律失常患者,以电脑Excel表格按照1∶1比例分为对比组和研究组,每组30例,对比组患者采用西地兰治疗,研究组患者采用西地兰联合胺碘酮治疗。比较两组患者治疗前后QT离散度、心功能指标及治疗后临床指标。结果治疗后,两组患者QT离散度均较本组治疗前降低,且研究组患者QT离散度(32.69±2.69)ms低于对比组的(41.32±3.11)ms,差异具有统计学意义(P<0.05)。治疗后,研究组患者心室率(78.51±5.17)次/min低于对比组的(94.23±6.67)次/min,起效时间(18.23±2.11)min短于对比组的(32.11±3.51)min,窦性心律转复率93.33%(28/30)高于对比组的70.00%(21/30),差异具有统计学意义(P<0.05)。治疗后,两组患者左室舒张末期内径、室间隔厚度、左室后壁厚度、左室重量指数、左室射血分数、舒张早期最大流速/舒张晚期最大流速(E/A)、N末端B型脑钠肽前体(NT-proBNP)水平均较本组治疗前改善,且研究组优于对比组,差异具有统计学意义(P<0.05)。结论在急诊重症心衰合并快速性心律失常患者治疗中选择西地兰联合胺碘酮用药方案,能够更好降低QT离散度,提高窦性心律转复率,且心室率更低、起效时间更短,同时,在改善心功能方面效果较显著。

Objective To discuss the clinical effect of cedilanid combined with amiodarone in the treatment of emergency department of patients with severe heart failure and tachyarrhythmia.Methods A total of 60 patients with severe heart failure and tachyarrhythmia in emergency department were divided into comparison group and research group at a ratio of 1∶1 using a computer Excel table,with 30 cases in each group.Patients in the control group were treated with cedilanid,and patients in the research group were treated with cedilanid in combination with amiodarone.The QT dispersion and cardiac function indexes before and after treatment,and clinical indexes after treatment were compared between the two groups.Results After treatment,the QT dispersion of the two groups was lower than those of this group before treatment,and the QT dispersion(32.69±2.69)ms of the research group was lower than(41.32±3.11)ms of the control group.All differences were statistically significant(P<0.05).After treatment,the ventricular rate(78.51±5.17)beats/min of the research group was lower than(94.23±6.67)beats/min of the control group,the onset time(18.23±2.11)min was shorter than(32.11±3.51)min of the control group,and the sinus rhythm cardioversion rate 93.33%(28/30)was higher than 70.00%(21/30)of the control group.All differences were statistically significant(P<0.05).After treatment,the left ventricular end-diastolic diameter,ventricular septal thickness,left ventricular posterior wall thickness,left ventricular mass index,left ventricular ejection fraction,early diastolic peak flow velocity of mitral valve,late diastolic peak flow velocity of mitral valve(E/A),N-terminal pro-brain natiuretic peptide(NT-proBNP)were improved compared with this group before treatment,and the research group was better than the control group.All differences were statistically significant(P<0.05).Conclusion In the treatment of emergency department of patients with severe heart failure and tachyarrhythmia,cedilanid combined with amiodarone can better reduce the QT dispersion,increase the sinus rhythm conversion rate,and have a lower ventricular rate and shorter onset time,and at the same time,it plays a more prominent role in improving heart function.