胺碘酮治疗充血性心力衰竭并室性心律失常临床分析

目的探讨胺碘酮治疗充血性心力衰竭(CHF)并室性心律失常的临床疗效及安全性。方法将62例CHF并室性心律失常患者随机分为治疗组及对照组,对照组给予常规抗心力衰竭治疗,治疗组在对照组的基础上加以应用胺碘酮治疗,对比分析两组患者在抗室性心律失常、左室射血分数、心脏性猝死、心力衰竭再住院率、药物不良反应等方面的情况。结果治疗组在抗室性心动过速(VT)、心脏性猝死、人均再住院次数、左室射血分数(LVEF)等各方面均明显优于对照组,差异有统计学意义(P<0.05)。结论在积极治疗心力衰竭且把握好剂量的基础上,胺碘酮对心力衰竭室性心律失常具有较好的疗效,是一种安全的抗心律失常药。     

胺碘酮治疗充血性心力衰竭临床分析

目的探讨胺碘酮治疗充血性心力衰竭心律失常的临床疗效与安全性。方法选取80例充血性心力衰竭(CHF)合并室性心律失常患者,随机分为对照组和治疗组,对照组给予常规抗心衰治疗,治疗组在对照组治疗基础上加用胺碘酮治疗,对比分析两组患者在心功能改善、抗心律失常、左室射血分数(LVEF)、心律衰竭再入院率及药物不良反应等反面的情况。结果胺碘酮组在抗心律失常、心功能改善、左室射血分数、心律衰竭再入院率等方面均明显优于对照组,差异有统计学意义(P<0.05)。结论胺碘酮是治疗充血性心力衰竭合并室性心律失常有效的药物,使用安全。     

胺碘酮联合美托洛尔治疗老年心力衰竭合并室性心律失常的效果评价

目的分析评价胺碘酮与美托洛尔联合治疗老年心力衰竭合并室性心律失常的效果。方法选取2014年6月至2016年2月时间段我院收治的72例心力衰竭合并室性心律失常的老年患者,作为研究对象,随机分为两组/36例,对照组患者使用胺碘酮治疗,观察组患者实施胺碘酮与美托洛尔联合治疗,比较两组患者治疗前后的心率变化和左心室射血分数以及不良反应发生概率等。结果经过治疗后,观察组患者的心率、左心室射血分数效果明显优于对照组,不良反应发生概率(2.78%)低于对照组,P<0.05。结论联合胺碘酮与美托洛尔对于治疗老年心力衰竭合并室性心律失常有较好的临床效果。     

冠心病慢性心力衰竭患者室性心律失常的临床治疗分析

目的：探讨冠心病慢性心力衰竭患者室性心律失常的临床治疗方法。方法选取2012年3月～2013年7月收治的冠心病慢性心力衰竭伴室性心律失常患者88例,随机将患者分为对照组及观察组各44例,对照组采用常规基础治疗,观察组在对照组治疗基础上加用胺碘酮,对比两组的临床疗效。结果观察组治疗总有效率为90.1%,对照组总有效率为63.6%,两组比较差异具有统计学意义（P＜0.05）。结论对冠心病慢性心力衰竭伴室性心律失常患者进行常规治疗基础上加用胺碘酮,可显著提高患者的治疗效果,且不良反应少。     

胺碘酮治疗充血性心力衰竭合并室性心律失常疗效观察

目的探讨胺碘酮治疗充血性心力衰竭并室性心律失常的疗效及安全性。方法将符合条件的160例充血性心力衰竭并室性心律失常患者随机分为治疗组及对照组,对照组给予常规抗心力衰竭加倍他乐克治疗,治疗组在常规治疗的基础上加胺碘酮治疗,对比分析两组患者在抗室性心律失常、左室射血分数、心脏性猝死、心力衰竭再住院率、药物不良反应等方面的情况。结果治疗组心功能改善和抗心律失常疗效优于对照组,再入院率和病死率低于对照组,差异有显著性（P〈0.05）,两组的不良反应无差异性（P〉0.05）。结论胺碘酮治疗充血性心力衰竭合并室性心律失常安全、有效,不良反应轻。     

胺碘酮治疗慢性充血性心力衰竭并室性心律失常疗效观察

目的观察胺碘酮治疗慢性充血性心力衰竭并室性心律失常疗效观察。方法78例慢性心力衰竭并室性心律失常患者均常规应用血管紧张素转换酶抑制剂,β-受体阻滞剂、利尿剂、地高辛等治疗,分组B组CHF治疗,A组给予加用胺碘酮0.2g,3次/d口服,逐渐减量,维持治疗直至观察终点。观察临床疗效,心功能改善情况,左室射血分数及药物不良反应。结果室性心律失常总有效率为88.2%,A组左室射血分数为(50.6±1.8),B组为(46.2±2.2),两组比较,差异有统计学意义(P<0.05)。A组的心力衰竭病死率15.1%,较B组(24.8%)减低(P<0.01),A组24个月内心力衰竭恶化再次住院率(12.0%),明显低B组(P<0.01)。治疗间A组4例出现不良反应,厌食2例,缓慢性心律失常2例,发生率10%。结论胺碘酮是治疗慢性充血性心力衰竭并室性心理失常安全和有效的药物之一。     

冠心病慢性心力衰竭患者室性心律失常的临床治疗

目的：对冠心病慢性心力衰竭患者室性心律失常的临床治疗进行探讨。方法将50例冠心病慢性心力衰竭伴室性心律失常患者随机分为观察组与对照组各25例。对照组采取常规治疗,观察组在对照组基础上给予胺碘酮进行治疗,观察比较2组患者的临床疗效。结果观察组的总有效率为84．00％高于对照组的68．00％,差异有统计学意义（P＜0．05）。结论冠心病慢性心力衰竭伴室性心律失常患者在进行治疗的过程中,采取胺碘酮配合常规治疗,可提高临床疗效。     

胺碘酮治疗充血性心力衰竭合并室性心律失常疗效观察

目的 对胺碘酮治疗充血性心力衰竭并室性心律失常的安全性及疗效进行探讨.方法 随机将160例符合条件的充血性心力衰竭并室性心律失常患者分为对照组及治疗组,在常规治疗的基础上加胺碘酮治疗于治疗组,给予常规抗心力衰竭加倍他乐克治疗于对照组,对比分析两组患者在抗室性心律失常、左室射血分数、心脏性猝死、心力衰竭再住院率、药物不良反应等方面的情况.结果 治疗组心功能改善和抗心律失常疗效优于对照组,再入院率和病死率低于对照组,差异有统计学意义(P＜0.05),两组的不良反应差异无统计学意义(P＞0.05).结论 胺碘酮治疗充血性心力衰竭合并室性心律失常安全、有效,不良反应轻.     

胺碘酮片联合酒石酸美托洛尔在心力衰竭伴室性期前收缩中的疗效分析

目的:观察胺碘酮片联合酒石酸美托洛尔在心力衰竭伴室性期前收缩中的临床应用效果.方法:对照组给予常规治疗+胺碘酮片,观察组在常规治疗基础上加用胺碘酮片、酒石酸美托洛尔进行治疗,对比分析两组室性期前收缩情况和心功能.结果:观察组疗效优于对照组(P<0.05).结论:应用胺碘酮片联合酒石酸美托洛尔在心力衰竭伴室性期前收缩中的临床疗效显著,具有较高的临床应用价值.     

胺碘酮联合美托洛尔治疗收缩性心力衰竭合并心律失常的效果观察

目的评价胺碘酮联合美托洛尔治疗收缩性心力衰竭合并心律失常的效果。方法选取2010年3月~2013年2月本院收治的34例收缩性心力衰竭合并心律失常患者,随机分为两组,各17例,对照组采用胺碘酮治疗,观察组采用胺碘酮联合美托洛尔治疗,比较两组的临床疗效、左心室射血分数、心率及不良反应发生率。结果观察组的总有效率为94.12%,对照组的总有效率为82.35%,差异有统计学意义（P〈0.05）;观察组治疗后的左心室射血分数高于对照组,心率慢于对照组,差异有统计学意义（P〈0.05）;观察组的不良反应发生率为5.88%,对照组的不良反应发生率为17.65%,差异有统计学意义（P〈0.05）。结论胺碘酮联合美托洛尔治疗收缩性心力衰竭合并心律失常效果好,安全系数高,值得临床推广应用。     

冠心病心力衰竭患者心脏结构与心律失常关系的探讨

目的探讨冠心病心力衰竭患者心脏结构改变与心律失常的关系。方法采用24h动态心电图、心动超声对140例冠心病心力衰竭患者进行检查和分析。结果冠心病心力衰竭患者室性心律失常（频发室早、非持续性室速、持续性室速、尖端扭转性室速、心室颤动）多见,其总发生率达52．14％,和左心室舒张末期内径（LVDd）、舒张末期室间隔厚度（IVST）、左心室后壁厚度（LVRD）有显著相关性。结论冠心病心力衰竭患者恶性室性心律失常的发生率和心脏结构改变有显著相关性,改善心脏重构,有利于预防恶性室性心律失常的发生。     

Congestive Heart Failure

Left ventricular systolic dysfunction is associated with neurohormonal activation which contributes to progressive ventricular remodeling and worsening clinical heart failure. Renin-angiotensin-aldosterone and sympathetic nervous systems are activated, not only in patients with clinically overt heart failure, but also in patients with asymptomatic or minimally symptomatic left ventricular systolic dysfunction. Activation of the angiotensin and adrenergic systems produces deleterious effects on systemic and coronary hemodynamics, promotes myocyte hypertrophy and fibroblast growth, and myocyte necrosis and apoptosis. Thus, therapy of heart failure should consist of pharmacologic agents not only to relieve symptoms but also to prevent and attenuate ventricular remodeling and progressive heart failure, thereby improving prognosis. In patients who are symptomatic, ACE inhibitors along with digitalis and diuretics as initial therapy (triple therapy) have the greater potential to improve exercise tolerance and decrease the incidence of treatment failure compared with diuretics alone or a combination of diuretics and digitalis. Diuretics alone should not be considered for long-term therapy as plasma renin activity, angiotensin II, aldosterone, norepinephrine and vasopressin levels may increase. ACE inhibitors decrease mortality in patients with heart failure resulting from left ventricular systolic dysfunction. The results of presently available studies indicate that angiotensin II receptor blockers (ARBs) do not provide any advantage over ACE inhibitors regarding survival benefit but may be better tolerated. Long-term adrenergic inhibition with the use of ß-adrenoceptor antagonists added to ACE inhibitors is associated with attenuation of ventricular remodeling, improvement in ventricular function and clinical class and survival of patients with symptomatic systolic left ventricular failure. Thus, initial pharmacotherapy for systolic heart failure should consist of: (i) maximal tolerated dosages of ACE inhibitors; (ii) ARBs if ACE inhibitors are not tolerated because of intractable cough or angioedema; (iii) adequate dosages of hydralazine and isosorbide dinitrate if ACE inhibitors or ARBs are not tolerated; (iv) relatively low dosages of digoxin (serum concentrations of ≤ 1.0 ng/dl) if not contraindicated; and (v) diuretics to relieve congestive symptoms. Addition of spironolactone to ACE inhibitors can result in a significant reduction in the risk of sudden death in patients with symptomatic severe heart failure. Myocardial infarction resulting from ischemic heart disease is the most common cause of systolic left ventricular failure and the therapeutic modalities with potential to reduce the risks of myocardial infraction, such as risk factor modification, adequate control of diabetes and hypertension, antiplatelet agents and lipid-lowering agents, should also be included in the initial therapy.     

Chronic Heart Failure

Heart failure (HF) is a complex syndrome characterized by the inability of the heart to maintain a normal cardiac output without elevated intracardiac filling pressures, resulting in signs of pulmonary and peripheral edema and symptoms of dyspnea and fatigue. Central to the management of HF is a multifaceted pharmacological intervention to abate the harmful counter-regulatory effects of neurohormonal activation and avid salt and water retention. Whereas up to 40 years ago HF was managed with diuretics and leaf of digitalis, the cornerstones of therapy for HF patients with systolic dysfunction now include ACE inhibitors or angiotensin II type 1 receptor antagonists (angiotensin receptor blockers), β-adrenoceptor antagonists (β-blockers), and aldosterone antagonists, which have significantly improved survival. However, with the increasing number of beneficial therapies, there are challenges to implementing all of them. Specific cardiomyopathies also merit specific considerations with respect to treatment, and — unfortunately — there is no therapy for HF with preserved left ventricular ejection fraction that has been shown to improve survival. Although mortality has improved in HF, the biggest challenge to treatment lies in addressing the morbidity of this disease, which is now the most common reason for hospital admission in our aged population. As such, there are many therapies that may serve to improve the quality of life of HF patients. Future HF treatment regimens may include direct cellular therapy via hormone and cytokine signaling or cardiac regeneration through growth factors or cell therapy.     

慢性肺源性心脏病合并冠心病的临床分析

目的探究慢性肺源性心脏病合并冠心病患者的临床特点和治疗方法。方法回顾性分析2010年1月至2011年12月期间,我院收治的56例慢性肺源性心脏病合并冠心病患者的临床资料,设为观察组,选取同期接受治疗的140例单纯肺心病患者设为对照组,比较两组患者的临床特点和超声检查结果。结果两组患者的心结扩大、心前区不适等方面无明显差异,差异无统计学意义,(P>0.05);心电图检查显示心肌梗死等病史、典型性心绞痛、电轴严重偏左、完全性左束支传导阻滞以及经X线检查提示左心室增大等症状对于合并冠心病具有诊断意义,具有统计学意义,(P<0.05)。结论根据患者的临床症状和体征,并结合心电图等检查能够有效的诊断肺心病合并冠心病症状,减少临床误诊和漏诊。     

左西孟坦治疗冠心病伴急性心力衰竭的疗效分析

目的对左西孟坦治疗冠心病伴急性心力衰竭的疗效进行分析。方法选取我院收治的冠心病伴急性心力衰竭患者80例,根据其入院编号分为实验组和对照组各40例,对照组:常规疗法,实验组:常规疗法+左西孟坦。结果实验组治疗总优良率为97.02%,对照组为80.00%,P<0.05,实验组用药后临床各项指标均优于对照组,P<0.05。结论临床上冠心病伴急性心力衰竭患者运用左西孟坦治疗效果良好,理应积极运用和推广。