胺碘酮治疗老年人心力衰竭并发室性心律失常临床观察

目的　观察胺碘酮治疗老年人心力衰竭并发室性心律失常的疗效和安全性。方法　选择 4 1例老年人慢性心力衰竭并发有症状的室性心律失常患者 ,经积极抗心力衰竭治疗病情稳定后加用胺碘酮 0 .2g ,每日 3次 ,连服 5～ 7天 ,然后改为 0 .2g ,每日 2次 ,连服 1周 ,之后以 0 .1～ 0 .2g ,每日 1次维持 ,疗程为 12周。观察治疗前后心功能、室性心律失常改善、心率、QT间期变化和不良反应。结果　治疗后 4 1例患者中 ,心功能提高 1级占 5 1.2 % ,室性心律失常治疗总有效率为 75 .6 % ,其中显效 12例(2 9.3% ) ,有效 19例 (46 .3% ) ,心率显著降低 (P <0 .0 1) ,QT间期延长 (P <0 .0 5 )。用药后有 2例出现窦性心动过缓 ,有 1例出现双手震颤 ,经减量或停药后恢复。结论　在积极抗心力衰竭治疗的基础上 ,应用胺碘酮治疗老年人心力衰竭并发室性心律失常是有效和安全的。

Clinical observation of amiodarone in the treatment of heart failure complicated by ventricular arrythmias in senile patients

Objective To investigate the efficacy and safety of amiodarone in the treatment of chronic heart failure complicated by ventricular arrythmias (VA)in the elderly.Methods 41 senile patients with chronic heart failure complicated by the symptoms of VA were selected in the study.After the positive treatment against heart failure,when the patients’ conditions were stable, amiodarone was taken orally,0.2g once, three times a day,lasting for 5～7 days,then which was taken 0.2g once,twice a day,lasting a week,finally,which was taken 0.1 g～0.2 g once,once a day,with a total treatment course of 12 weeks.Before and after the treatment the heart function,improvement of VA,heart rate,change of Q-T interval and side-effect were observed.Results After the treatment,among 41 patients,the patients whose heart function was elevated by 1 grade acconuted for 51.2%,and the total effective rate for VA was 75.6% ,including obvious effective rate 29.3% and effective rate 46.3%.There also was a significant decrease of heart rate(P<0.01)and a slight prolongation of Q-T interval (P<0.05).With regard to the side-effect,sinus bradycardia was found in two cases and hands tremor in one case,which could disappear after withdrawal or decrease of administration.Conclusion On the basis of positive treatment against heart failure,the administration of amiodarone for senile patients with heart failure complicated by VA is effective and safe.