张跃军

摘要：目的：对HF伴室心律失常患者联合应用胺碘酮+厄贝沙坦治疗，并分析其临床效果。方法：选取2018年11月—2020年10月，在我院治疗的88例HF伴室心律失常患者，将其分为两组。对照组44例，使用胺碘酮治疗;观察组44例，在此基础上，联用厄贝沙坦治疗。结果：治疗后，观察组患者的LVEF、每分输出量明显高于对照组，LVESD明显小于对照组（P < 0.05）;观察组患者治疗1个月、3个月、6个月的窦性心律维持率均明显高于对照组（P < 0.05）;观察组患者不良反应率为13.64%，对照组为18.18%，无明显差异（P > 0.05）。结论：对HF伴室心律失常应用胺碘酮+厄贝沙坦治疗可更好地改善患者心功能，维持其窦性心律，且安全性良好。

关键词：慢性心力衰竭;室心律失常;厄贝沙坦;胺碘酮

The Clinical Effect of Amiodarone and Irbesartan in the Treatment of Chronic Heart Failure with Ventricular Arrhythmia

Yue-Jun Zhang*

Zhangjiakou Xiahuayuan District Hospital， Zhangjiakou 075300， Hebei， China

Abstract： Objective： To analyze the clinical effect of amiodarone combined with irbesartan in HF patients with ventricular arrhythmia. Method： From November 2018 to October 2020， 88 HF patients with ventricular arrhythmia in our hospital were selected and divided into two groups. 44 cases in the control group were treated with amiodarone; 44 cases in the observation group were treated with irbesartan on this basis. Result： After treatment， the LVEF and output per minute of the observation group were significantly higher than those of the control group， and the LVESD was significantly lower than that of the control group （P < 0.05）; the sinus rhythm maintenance rate of the observation group was significantly higher than that of the control group （P < 0.05）; the adverse reaction rate of the observation group was 13.64%， and that of the control group was 18.18%， with no significant difference （P > 0.05）. Conclusion： Amiodarone combined with irbesartan in the treatment of HF with ventricular arrhythmia can better improve the cardiac function of patients， maintain its sinus rhythm， and has good safety.

Keywords： Chronic heart failure; ventricular arrhythmia; Irbesartan; Amiodarone

一、前言

慢性心力衰竭（HF）是心內科常见疾病，主要发病群体为中老年人。该病主要为心脏疾病、心血管病变长期进展所致，由于心室负荷增加，心脏收缩、舒张能力下降，心脏泵血能力受到影响，回心血量不足，难以维持正常心脏循环，最终形成HF[1]。随着HF病情的进展，患者可出现心律失常，威胁其生命安全。在该类患者临床治疗时，不仅需要缓解HF症状、延缓病情进展，还需要纠正心律失常[2]。目前，临床上常用的抗心律失常药物较多，但大部分药物均具有一定的降低心肌收缩的作用，可能导致患者心脏泵血能力进一步下降，HF病情加重。因此，在选择临床用药时应更加谨慎。胺碘酮是一种常用的肾上腺素术受体拮抗剂类抗心律失常药物，与其他抗心律失常药物相比，其负性肌力作用更低。……