胺碘酮联合厄贝沙坦对心衰并心律失常的疗效

目的:研究胺碘酮联合厄贝沙坦治疗心力衰竭合并心律失常患者的疗效。方法:本院2015年3月~2018年5月间收治的110例心力衰竭合并心律失常患者被随机均分为胺碘酮组和联合治疗组(在胺碘酮组基础上加用厄贝沙坦),两组均接受常规治疗疗程6个月。观察比较两组治疗前后心输出量(CO)、LVEF、左室收缩末内径(LVESd)、左室舒张末内径(LVEDd)、血清基质金属蛋白酶(MMP)-9、血浆脑钠肽(BNP)、醛固酮(ALD)和血管紧张素II(AngII)水平,疗效和不良反应。结果:两组治疗总有效率无显著差异,P=0.435。与胺碘酮组比较,治疗后联合治疗组CO(4.21±0.29)L/min比(4.41±0.32)L/min]、LVEF(45.58±0.98)%比(46.12±1.16)%]均显著升高,LVESd(55.03±3.02)mm比(53.46±3.14)mm]、LVEDd(59.12±3.36)mm比(57.65±2.97)mm]、血清MMP-9(163.96±17.83)μg/L比(154.69±16.72)μg/L]、血浆BNP(821.84±216.42)pg/ml比(736.37±209.35)pg/ml]、ALD(416.79±17.94)pg/ml比(408.96±16.87)pg/ml]和AngII(165.72±19.81)pg/ml比(156.95±18.42)pg/ml]水平均显著降低,P<0.05或<0.01。治疗6个月,两组不良反应发生率无显著差异,P=0.340。结论:胺碘酮与厄贝沙坦联合治疗心衰并心律失常疗效显著,能够显著改善患者心功能,降低BNP、MMP-9水平,值得推广。

Therapeutic effect of amiodarone combined irbesartan on patients with heart failure complicated arrhythmia

Objective:To study therapeutic effect of amiodarone combined irbesartan on patients with heart failure complicated arrhythmia.Methods:A total of 110 patients with heart failure complicated arrhythmia,who were treated in our hospital from Mar 2015 to May 2018,were randomly and equally divided into amiodarone group and combined treatment group(received irbesartan based on amiodarone),both groups received corresponding medication based on routine treatment for six months.Cardiac output(CO),LVEF,left ventricular end-systolic dimension(LVESd),left ventricular end-diastolic dimension(LVEDd),levels of serum metalloproteinase(MMP)-9,plasma brain natriuretic peptide(BNP),aldosterone(ALD)and angiotensin(Ang)II before and after treatment,therapeutic effect and incidence of adverse reactions were observed and compared betw een two groups.Results:There was no significant difference in total effective rate between two groups,P=0.435.Compared with amiodarone group after treatment,there were significant rise in CO(4.21±0.29)L/min vs.(4.41±0.32)L/min],LVEF(45.58±0.98)%vs.(46.12±1.16)%],and significant reductions in LVESd(55.03±3.02)mm vs.(53.46±3.14)mm],LVEDd(59.12±3.36)mm vs.(57.65±2.97)mm],levels of serum MMP-9(163.96±17.83)μg/L vs.(154.69±16.72)μg/L],plasma BNP(821.84±216.42)pg/ml vs.(736.37±209.35)pg/ml],ALD(416.79±17.94)pg/ml vs.(408.96±16.87)pg/ml]and AngII(165.72±19.81)pg/ml vs.(156.95±18.42)pg/ml]in combined treatment group,P<0.05 or<0.01.During six-month treatment,there was no significant difference in incidence rate of adverse reactions betwee n two groups,P=0.340.Conclusion:Amiodarone combined irbesartan possesses significant therapeutic effect on patients with heart failure complicated arrhythmia.It can significantly improve cardiac function,reduce levels of BNP and MMP-9,which is worth extending.