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小剂量胺碘酮与倍他乐克治疗肥厚型心肌病合并恶性室性心律失常的效果比较。

Effects of low-dose amiodarone and Betaloc on the treatment of hypertrophic cardiomyopathy complicated with malignant ventricular arrhythmias.

机构信息

Yu Gao, Second Department of Cardiology, The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, P. R. China.

Peisheng Zhang, Second Department of Cardiology, The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, P. R. China.

出版信息

Pak J Med Sci. 2014 Mar;30(2):291-4.

Abstract

OBJECTIVE

To study the therapeutic effects of low-dose amiodarone and Betaloc on hypertrophic cardiomyopathy complicated by malignant ventricular arrhythmias.

METHODS

Eighty-two such patients were selected and divided into a treatment group and a control group by the random number method (n=41), which were administered with low-dose amiodarone plus Betaloc and individual Betaloc respectively.

RESULTS

The treatment group had a significantly higher overall effective rate (85.4%) than the control group (65.9%) did. Based on the New York Heart Association's classification of cardiovascular disease, the treatment group mainly comprised Class III and IV patients before treatment, which were significantly relieved after treatment (P<0.05). The heart rate was evidently decreased from (119.99±18.91) bpm to (80.98±12.34) bpm, and the incidences of premature ventricular contraction and tachycardia were significantly reduced (P<0.05). The longest QT intervals after and before treatment were (421±32) ms and (411±35) ms respectively. The shortest QT interval after treatment [(350±36) ms] was significantly longer than that before [(307±31) ms]. The QT dispersion before treatment [(96±29) ms] was significantly higher that after [(64±17) ms] (P<0.05). Six out of eighty two patients in the treatment group succumbed to adverse reactions (14.63%).

CONCLUSION

Hypertrophic cardiomyopathy complicated with malignant ventricular arrhythmias can be well treated with low-dose amiodarone and Betaloc, with mitigated symptoms, improved prognosis and few adverse reactions.

摘要

目的

研究小剂量胺碘酮和倍他乐克治疗肥厚型心肌病并发恶性室性心律失常的疗效。

方法

选择 82 例肥厚型心肌病并发恶性室性心律失常患者,采用随机数字表法分为治疗组和对照组(n=41),分别采用小剂量胺碘酮联合倍他乐克、倍他乐克个体化治疗。

结果

治疗组总有效率(85.4%)明显高于对照组(65.9%)。根据纽约心脏病协会(NYHA)心血管病分级,治疗组治疗前主要为Ⅲ、Ⅳ级患者,治疗后明显缓解(P<0.05)。心率从(119.99±18.91)次/min 明显下降至(80.98±12.34)次/min,室性早搏和心动过速的发生率明显降低(P<0.05)。治疗前后最长 QT 间期分别为(421±32)ms 和(411±35)ms,治疗后最短 QT 间期(350±36)ms 明显长于治疗前(307±31)ms,治疗前 QT 离散度(96±29)ms 明显高于治疗后(64±17)ms(P<0.05)。治疗组 82 例患者中有 6 例死亡(14.63%)。

结论

小剂量胺碘酮和倍他乐克治疗肥厚型心肌病并发恶性室性心律失常,可有效缓解症状,改善预后,不良反应少。

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