冠心病慢性心力衰竭合并室性心律失常治疗方案的探讨

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目的探讨冠心病慢性心力衰竭合并室性心律失常的治疗方案。方法选取2013年4月至2015年2月安阳市灯塔医院收治的冠心病慢性心力衰竭合并室性心律失常患者82例为研究对象,采用随机数表法分为观察组和对照组各41例,对照组采用临床基础性疗法,使用血管紧张素转换酶抑制剂或血管紧张素II拮抗剂、B受体阻滞剂、利尿剂及纠正电解质紊乱等方法治疗,观察组在基础性疗法上加用胺碘酮治疗,比较两组治疗有效率,同时记录其治疗前后心率(HR)、左室射血分数(LVEF)、室性早搏总数,并观察不良反应。结果观察组治疗总有效率87.80%明显高于对照组68.29%(P<0.05);治疗后两组HR、室性早搏总数均下降,LVEF均升高,且观察组HR(100.44±0.21)次/min、室性早搏总数(969±65)个/d明显低于对照组,观察组LVEF(52.17±1.63)%与对照组比较明显较高,差异具有统计学意义(P均<0.05);观察组不良反应发生率12.20%与对照组7.32%比较无显著差异(P>0.05)。结论胺碘酮可有效改善冠心病慢性心力衰竭合并室性心律失常患者心律失常病情,且安全性高,值得在临床推广应用。 Objective To investigate the treatment of chronic heart failure with ventricular arrhythmia in patients with coronary heart disease. Methods From April 2013 to February 2015, Anyang City Lighthouse Hospital admitted to coronary heart disease patients with chronic heart failure in 82 cases of ventricular arrhythmias were studied by random number table divided into observation group and control group of 41 cases, Control group using clinical basic therapy, the use of angiotensin converting enzyme inhibitors or angiotensin II antagonist, B receptor blockers, diuretics and correct electrolyte disorders and other methods of treatment, the observation group in the basic therapy plus Amiodarone treatment, the treatment efficiency was compared between the two groups, while heart rate (HR), left ventricular ejection fraction (LVEF), premature ventricular contractions were recorded before and after treatment, and adverse reactions were observed. Results The total effective rate of the observation group was 87.80%, which was significantly higher than that of the control group (68.29%, P <0.05). After treatment, the total number of HR and ventricular premature beats decreased, LVEF increased, and the observation group HR (100.44 ± 0.21) / min, and the total number of premature ventricular contractions (969 ± 65) / d was significantly lower than that of the control group. The LVEF in the observation group was significantly higher than that of the control group (52.17 ± 1.63)%, the difference was statistically significant (all P <0.05) The incidence of adverse reactions in the observation group was not significantly different from that in the control group (12.20% vs 7.32%, P> 0.05). Conclusions Amiodarone can effectively improve the arrhythmia in patients with CHD complicated by ventricular arrhythmia and is safe and worthy of clinical application.
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