摘要
目的观察心力衰竭合并心律失常患者采用厄贝沙坦联合胺碘酮治疗的有效性、安全性。方法选取2018年8月—2020年8月武汉亚洲心脏病医院心内科收治的心力衰竭合并心律失常患者96例为研究对象,按照随机数字表法分为观察组和对照组,每组48例。在常规对症治疗基础上,对照组单独使用胺碘酮治疗,观察组在对照组基础上给予厄贝沙坦治疗,2组疗程均为6个月。比较2组治疗总有效率,治疗前后实验室指标[血浆型脑钠肽(BNP)、血清基质金属蛋白酶-9(MMP-9)、醛固酮(ALD)]、心功能指标[左心室射血分数(LVEF)、左心室收缩末期内径(LVESd)、左心室舒张末期内径(LVEDd)]变化及用药安全性。结果观察组患者治疗总有效率为95.83%,高于对照组的81.25%(χ^(2)=5.031,P=0.025);治疗6个月后,2组MMP-9、BNP、ALD水平均较治疗前降低,且观察组低于对照组(P均<0.01);2组LVEF较治疗前升高,LVESd、LVEDd较治疗前减小,且观察组升高/减小幅度大于对照组(P<0.05或P<0.01);2组患者胃肠道反应、窦性心律过缓等总发生率比较差异无统计学意义(χ^(2)=0.381,P=0.537)。结论厄贝沙坦联合胺碘酮用药方案既有效又安全可靠,利于调节心力衰竭合并心律失常患者实验室指标变化,改善心功能,促进病情恢复,保障用药安全。
Objective To observe the efficacy and safety of irbesartan combined with amiodarone in the treatment of heart failure patients with arrhythmia.Methods A total of 96 patients with heart failure and arrhythmia admitted to the Department of Cardiology,Wuhan Asian Heart Hospital from August 2018 to August 2020 were selected as the research objects,and divided into an observation group and a control group according to the random number table method,with 48 cases in each group.On the basis of routine symptomatic treatment,the control group was treated with amiodarone alone,and the observation group was treated with irbesartan on the basis of the control group.The treatment course of the two groups lasted for 6 months.The total effective rate of the two groups of treatment was compared.The changes of laboratory indexes(BNP,MMP-9,ALD)and cardiac function indexes(LVEF,LVESd,LVEDd)were compared between the two groups before and after treatment.Comparison of drug safety between two groups.Results The total effective rate of patients in the observation group was 95.83%,which was higher than 81.25%in the control group(χ^(2)=5.031,P=0.025).After 6 months of treatment,the levels of MMP-9,BNP and ALD in the two groups were lower than those before treatment,and the observation group was lower than the control group(all P<0.01);LVEF in the two groups increased compared with before treatment,LVESd and LVEDd decreased compared with before treatment,and the increase/decrease in the observation group was greater than that in the control group(P<0.05 or P<0.01).There was no significant difference in the total incidences of gastrointestinal reactions and sinus bradycardia between the two groups(χ^(2)=0.381,P=0.537).Conclusion The irbesartan combined with amiodarone medication regimen is effective,safe and reliable,which is beneficial to regulate the changes of laboratory indicators in patients with heart failure and arrhythmia,improve cardiac function,promote disease recovery,and ensure medication safety.
作者
罗萍
LUO Ping(Wuhan Asian Heart Hospital,Hubei Province,Wuhan 430000,China)
出处
《临床合理用药杂志》
2022年第23期5-8,共4页
Chinese Journal of Clinical Rational Drug Use
