胺碘酮治疗老年人心力衰竭并发室性心律失常临床观察.docVIP

精品论文 参考文献 胺碘酮治疗老年人心力衰竭并发室性心律失常临床观察 刘虹 （天津市北辰区天穆医院 300130） 【摘要】目的:观察胺碘酮治疗老年人心力衰竭并发室性心律失常的疗效和安全性。方法:选择41例老年人慢性心力衰竭并发有症状的室性心律失常患者，经积极抗心力衰竭病情稳定后加用胺碘酮0.2g，每日3次，连服5～7天，然后改为0.2g，每日2次，连服一周，之后以0.1～0.2g，每日一次维持，疗程为12周。观察治疗前后心功能、室性心律失常改善、心率、QT间期变化和不良反应。结果:治疗后41例患者中，心功能提高1级占51.2%，室性心律失常治疗总有效率为75.6%，其中显效12例（29.3%），有效19例（46.3%），心率显著降低（p lt;0.01），QT间间延长（p lt;0.05）。用药后有2例出现窦性心动过缓，有1例出现双手震颤，经减量式停药后恢复。结论:在积极抗心力衰竭治疗的基础上，应用胺碘酮治疗老年人心力衰竭并发室性心律失常是有效和安全的。 【关键词】 老年人；心力衰竭；室性心律失常；胺碘酮 【Abstract】Objective To observe the amiodarone in elderly patients with heart failure complicated by ventricular arrhythmia efficacy and safety. Methods 41 cases of elderly patients with chronic heart failure complicated by symptomatic ventricular arrhythmias in patients with positive anti-heart failure in stable condition after the addition of amiodarone after 0.2g, 3 times a day, even for 5 to 7 days, then changed to 0.2g, 2 times a day, even for a week, then to 0.1 ~ 0.2g, daily maintenance, treatment for 12 weeks. Cardiac function before and after treatment, improvement of ventricular arrhythmias, heart rate, QT interval changes and adverse reactions. Results After treatment, 41 patients, heart function improved a 51.2%, ventricular arrhythmia total effective rate was 75.6%, which markedly effective in 12 cases (29.3%), effective in 19 cases (46.3%), heart rate was significantly lower ( p amp;lt;0.01), QT had extended between (p amp;lt;0.05). After treatment, 2 patients had sinus bradycardia, 1 patient had hand tremors, after stopping by the reduction-style resume. Conclusion active in anti-heart failure therapy based on the application of amiodarone in elderly patients with heart failure complicated by ventricular arrhythmia is effective and safe. 【Key words】Older; Heart failure; Ventricular arrhythmias; Amiodarone 【中图分类号】R972.2【文献标识码】A【文章编号】1007-8231（2011）07-0557-02 心力衰竭者常因并发室性心律失常而死，症状性室性心律失常复发率很高，心力衰竭患者一旦有症状性室性心律失常即为心源猝死的高危患者，心源性猝死约占心力衰竭总死亡的30%～70%［1］。我们应用胺碘酮治疗老年人心力衰竭并发室性心律失常，取得较好疗效，报道如下。