胺碘酮治疗老年慢性心力衰竭合并室性心律失常84例临床观察

目的:观察胺碘酮治疗老年人心力衰竭合并室性心律失常的有效性和安全性。方法:对84例慢性心力衰竭并发有症状的室性心律失常患者,经常规抗心力衰竭治疗病情稳定后,给予口服胺碘酮0.2 g,每日3次,连服5~7天,然后改为0.2 g,每日2次,连服l周,之后以0.1~0.2 g,每日l次维持,疗程8周,应用24小时动态心电图、超声心动图评价治疗室性心律失常效果、心功能变化、心率、QT间期变化和不良反应。结果:治疗后84例患者中,心功能提高1级者占84%,室性心律失常治疗总有效率为74%,其中显效39例(46%),有效24例(28%),心率显著降低,QT间期延长。用药后有4例出现窦性心动过缓,经减量或停药后恢复。治疗前后左室射血分数(LVEF)差异有统计学意义(P<0.001),未出现严重不良反应。结论:胺碘酮治疗老年人慢性心力衰竭合并室性心律失常是有效和安全的。

Clinical observation of amiodarone in the treatment of chronic heart failure complicated by ventricular arrhythmias in 84 cases of senile patients

Objective: 84 patients with chronic heart failure complicated with symptomatic ventricular arrhythmia were selected in this study.Methods:After effective conventional treatment against heart failure,the patients were assigned to receive oral amiodarone by 0.2 g,3 times a day for 5~7 days,then the 0.2 g,twice a day for a week,followed by 0.1~0.2 g,once a day for 8 weeks or on a long-term basis.Before and after the treatment the heart function,improvement of VA,heart rate,change of Q-T internal and side-effect were observed.Results:After the treatment,among 84 patients,the patients whose heart function was elevated by 1 grade accounted for84 %,and the total effective rate for VA was 74%,including obvious effective rate 46% and effective rate 29%.There also was a significant decrease of heart rate and a slight prolongation of Q-T internal.With regard to the side-effect,sinus bradycardia was found in4cases,which disappeared 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.