魏春霞　席玉胜

[摘要] 目的 研究老年重度心力衰竭合并快速心律失常患者使用靜脉注射胺碘酮治疗的临床效果。 方法 选取2017年1月至2020年2月我院治疗的老年重度心力衰竭合并快速心律失常患者200例，使用抽签法将其分为常规组和胺碘酮组，每组各100例。常规组采取常规治疗，胺碘酮组在常规治疗基础上给予静脉注射胺碘酮治疗。比较两组疗效、不良反应发生率、射血分数（EF）、平均动脉压（MAP）、心脏指数（CI）、E峰与A峰比值（E/A）、心率、血压变化情况，并使用日常生活能力量表（ADL）对两组生活质量进行评价，对比两组满意度。 结果 胺碘酮组总有效率为98.00%，明显高于常规组的85.00%，差异有统计学意义（P<0.05）。胺碘酮组不良反应发生率为3.00%，明显低于常规组的16.00%，差异有统计学意义（P<0.05）;胺碘酮组满意度为99.00%，明显高于常规组的89.00%，差异有统计学意义（P<0.05）。治疗前两组EF、MAP、CI、E/A、ADL评分、心率、收缩压、舒张压比较，差异无统计学意义（P>0.05）。治疗后，胺碘酮组EF、MVP、CI、E/A及ADL评分均高于常规组，差异有统计学意义（P<0.05）。治疗后，胺碘酮组心率低于常规组，收缩压与舒张压均高于常规组，差异有统计学意义（P<0.05）。 结论 对老年重度心力衰竭合并快速心律失常患者给予静脉注射胺碘酮具有显著疗效，可改善其各项血流动力学指标及血压等，稳定患者病情，且不良反应发生率少，安全性高，可改善患者预后，提升患者满意度与生活质量，值得临床应用与推广。

[关键词] 重度心力衰竭;快速心律失常;静脉注射;胺碘酮

[中图分类号] R541.6          [文献标识码] B          [文章编号] 1673-9701（2021）06-0049-04

Therapeutic efficacy of intravenous amiodarone in elderly patients with severe cardiac failure complicated with tachyarrhythmia

WEI Chunxia   XI Yusheng

Department of Cardiology， 74th Military Hospital of PLA， Guangzhou   510310， China

[Abstract] Objective To explore the clinical efficacy of intravenous amiodarone in elderly patients with severe cardiac failure complicated with tachyarrhythmia. Methods A total of 200 elderly patients with severe cardiac failure complicated with tachyarrhythmia admitted to our hospital from January 2017 to February 2020 were selected and divided into the conventional group and the amiodarone group by drawing lots， with 100 cases in each group. The therapeutic efficacy， the incidence of adverse reactions（ADRs）， the changes of ejection fraction （EF）， mean arterial pressure （MAP）， cardiac index（CI）， ratio of E peak to A peak（E/A）， heart rate and blood pressure were compared between the two groups. Meanwhile， the ability of daily living（ADL） was used to evaluate the quality of life of the two groups. The satisfaction of the two groups was compared. Results The total efficacy rate in the amiodarone group was 98.00%， which was higher than that of 85.00% in the conventional group， with significant difference（P<0.05）. The incidence of ADRs in the amiodarone group was 3.00%， which was lowwer than that of 16.00% in the conventional group， and the differences were statistically significant（P<0.05）. The degree？of？satisfaction in the amiodarone group was 99.00%， which was higher than that of 89.00% in the conventional group， with significant difference（P<0.05）. Before treatment， there were no differences in EF， MAP， CI， E/A， ADL score， HR， SBP and DBP between the two groups（P>0.05）. After treatment， EF， MAP， CI， E/A， ADL score in the amiodarone group were higher than those in the conventional group， and the differences were statistically significant（P<0.05）. After treatment， HR in the amiodarone group was lower than that in the conventional group， SBP and DBP in the amiodarone group were higher than those in the conventional group， and the differences were statistically significant（P<0.05）. Conclusion Intravenous amiodarone has obvious therapeutic efficacy for elderly patients with severe cardiac failure complicated with tachyarrhythmia， which can improve the hemodynamic indexes and blood pressure and stabilize the patients′ condition， with lower incidence of ADRs and higher safety. Therefore， it can improve the prognosis of patients and enhance their satisfaction and quality of life， which is worthy of application and promotion.

[Key words] Severe cardiac failure; Rapid arrhythmia; Intravenous injection; Amiodarone

近年来，随着我国老龄化人口逐渐增加，我国心力衰竭发病率也随之上升，依据世界卫生组织（World Health Organization，WHO）统计，65岁以上心力衰竭发病率为7.4%，80岁以上则高达10%[1]。心力衰竭是由各种因素导致心脏结构或功能发生衰退性损伤，以此影响心室充盈及射血能力的一种临床综合征，对患者生命安全造成严重威胁。心力衰竭发生与心律失常具有密切联系，多数心力衰竭患者常伴有一定程度的心律失常，其中以室性心律失常最为多见，若室性心动过速则会严重影响患者血流动力学，从而造成心力衰竭患者病情恶化。若不尽早对重度心力衰竭合并快速心律失常患者采取有效的治疗措施，极易造成血流动力学异常。……