胺碘酮联合厄贝沙坦治疗心力衰竭合并心律失常的有效性及对患者心功能的改善作用

Efficacy of amiodarone combined with irbesartan in the treatment of heart failure complicated with arrhythmia and improvement of cardiac function

目的探究胺碘酮联合厄贝沙坦治疗心力衰竭合并心律失常的有效性及对患者心功能的改善作用。方法选取2019年1—12月湖北省荣军医院收治的64例心力衰竭合并心律失常患者作为研究对象,随机分为观察组与对照组,每组32例。对照组行胺碘酮治疗,观察组在对照组基础上联合厄贝沙坦治疗。比较两组心功能相关指标[左心室射血分数(LVEF)、每搏心输出量(SV)、QT离散度、心率(HR)]、舒张压(DBP)、收缩压(SBP)、血管内皮功能[一氧化氮(NO)、血栓素2(TXB2)、内皮素(ET)]、不良反应发生情况、临床疗效。结果治疗后,两组LVEF均高于治疗前,SV均大于治疗前,QT离散度均低于治疗前,HR均慢于治疗前,且观察组LVEF高于对照组,SV大于对照组,QT离散度低于对照组,HR慢于对照组,差异有统计学意义(P<0.05)。治疗后,两组DBP、SBP均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。治疗后,两组NO水平均高于治疗前,TXB2、ET水平均低于治疗前,且观察组NO水平高于对照组,TXB2、ET水平均低于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义。观察组治疗总有效率为93.75%,高于对照组的71.88%,差异有统计学意义(P<0.05)。结论胺碘酮联合厄贝沙坦治疗心力衰竭合并心律失常患者效果确切,不良反应少,且可明显改善患者心功能、血压及血管内皮功能,值得临床推广应用。

Objective To observe the efficacy of amiodarone combined with irbesartan in the treatment of heart failure complicated with arrhyth-mia and improvement of cardiac function.Methods 64 patients with heart failure complicated with arrhythmia treated in Hubei Province Veterans Hospital from January to December 2019 were selected as the research subjects and they were randomly divided into the observation group and con-trol group,with 32 cases in each group.The control group was treated with amiodarone,and the observation group was treated with irbesartan on the basis of the control group.The cardiac function related indexes(left ventricular ejection fraction[LVEF],stroke volume[SV],QT dispersion,heart rate[HR]),diastolic blood pressure(DBP),systolic blood pressure(SBP),vascular endothelial function(nitric oxide[NO],thromboxane 2[TXB2],endothelin[ET]),adverse reactions and clinical efficacy were compared between the two groups.Results After treatment,the LVEF of the two groups were higher than those before treatment,SV were larger than those before treatment,QT dispersion were lower than those before treatment,HR were slower than that before treatment,and the LVEF in the observation group was higher than that in the control group,SV was larger than that in the control group,QT dispersion was lower than that in the control group,HR was slower than that in the control group,the differences were statis-tically significant(P<0.05).After treatment,DBP and SBP of the two groups were lower than those before treatment,and the observation group was lower than the control group,the differences were statistically significant(P<0.05).After treatment,the levels of NO of the two groups were higher than those before treatment,the levels of TXB2 and ET were lower than those before treatment,and the level of NO in the observation group was higher than the control group,the levels of TXB2 and ET were lower than the control group,the differences were statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups.The total effective rate of treatment in the observation group was 93.75%,which was higher than 71.88%in the control group,and the difference was statistically significant(P<0.05).Conclusion Amioda-rone combined with irbesartan is effective in the treatment of patients with heart failure complicated with arrhythmia,with few adverse reactions,and can significantly improve the cardiac function,blood pressure and vascular endothelial function of patients,which is worthy of clinical promotion and application.