厄贝沙坦联合胺碘酮治疗充血性心力衰竭合并室性心律失常的临床观察

目的 探讨厄贝沙坦联合胺碘酮治疗充血性心力衰竭合并室性心律失常的临床疗效及安全性.方法 70例充血性心力衰竭合并室性心律失常患者随机分为治疗组和对照组各35例.两组均予强心、利尿、扩血管及β受体阻滞剂,以及胺碘酮200 mg,每日3次口服,1周后改为每日3次,2周后改为每日3次,逐渐减小到维持量.治疗组同时加用厄贝沙坦起始剂量为每日80 mg,如无不适,改为每日160 mg.结果 治疗后,两组患者HR治疗后明显降低,且治疗组较对照组的HR降低更显著,差异具有显著性意义（P＜0.05）,两组患者的LVEF治疗后均较治疗前明显升高,且治疗组较对照组升高更显著（P＜0.05）.治疗组患者治疗后的总有效率达91.4％,明显高于对照组的总有效率74.3％（P＜0.05）.观察组出现血压降低1例,静脉炎1例,心动过缓1例.对照组出现血压降低3例,静脉炎3例,心动过缓2例;两组不良反应发生率比较,差异无显著性（8.57％vs 22.86％,P＞0.05）.结论 厄贝沙坦联合胺碘酮治疗充血性心力衰竭合并室性心律失常具有较好的临床效果及安全性,值得推广和应用.

Clinical observation of irbesartan combined with amiodarone on congestive heart failure with ventricular arrhythmias

Objective To investigate the clinical efficacy and safety of irbesartan and amiodarone in treatment of congestive heart failure with ventricular arrhythmia. Methods Seventy eases of congestive heart failure with ventricular arrhythmias were randomly divided into treatment group and control group, each of 35 cases. Two groups were treated with cardiac, diuretic , vasodilator and β-blockers and amiodarone 200 mg, 3 times a day orally, 1 to 3 times a week , two weeks later changed daily 3 times, gradually reduced to a maintenance dose. Irbesartan treatment group added in the initial daily dose of 80 mg, if there was no discomfort, changed daily 160 mg. Results After treatment, HR of two group＇s patients were significantly reduced and the treatment group reduced more significantly than the control group, the difference was significant （P 〈0.05）, LVEF increased than before treatment, and the treatment group increased more significantly than in the control group （P 〈0.05）. The total effective rate was 91.4% in the treatment group after treat- ment, significantly higher than the control group of 74.3% （P 〈0.05）. Observation group had lower blood pressure one case, one case of phlebitis, bradycardia one case. Control group had lower blood pressure in 3 cases, 3 cases of phlebitis, bradycardia two cases; The difference of incidence of adverse reactions in two groups was not significant （8.57% vs 22.86%, P〉0.05）. Conclusion Irbesartan combined amiodarone in treatment of congestive heart failure with ventricular arrhythmias have better clinical efficacy and safety, worthy of promotion and application.