盐酸胺碘酮对冠心病合并心律失常患者血黏度及hs-CRP的影响

摘要

目的 探讨冠心病伴心律失常患者采用盐酸胺碘酮片治疗对其超敏C-反应蛋白(hypersensitive C reactive protein,hs-CRP)及血黏度的影响.方法 选取河北工程大学附属医院2014年6月—2017年6月就诊的冠心病伴心律失常患者122例,随机分为2组各61例,常规组给予盐酸普罗帕酮片治疗,研究组给予盐酸胺碘片治疗,对比2组hs-CRP含量、血黏度、心律变化和治疗疗效情况.结果 治疗后研究组血细胞比容、血浆比黏度、纤维蛋白原、细胞沉降率、低切变率下全血黏度、高切变率下全血黏度等指标均低于常规组,差异有统计学意义(P<0.05);研究组与常规组PR间期、QRS波时限差异无统计学意义(P>0.05);研究组QTc间期高于常规组,差异有统计学意义(P<0.05);研究组室早数、短阵室速数低于常规组,差异有统计学意义(P<0.05);研究组hs-CRP含量低于常规组,差异有统计学意义(P<0.05);研究组治疗总有效率高于常规组,差异有统计学意义(P<0.05).结论 冠心病伴心律失常患者给予盐酸胺碘酮片治疗疗效显著,可有效改善患者血黏度,调节血清中hs-CRP含量,且无明显不良反应.%Objective To investigate the effect of amiodarone hydrochloride tablets on hs-CRP and hemodynamics in patients with coronary heart disease complicated with arrhythmia.Methods 122 cases of patients with coronary heart disease and arrhythmia treated in our hospital between June 2014 and June 2017 were randomly divided into two groups: the conventional group (61 cases) that was treated with propatenone hydrochloride tablets and the study group (61 cases) which was treated with amiodarone hydrochloride tablets. The therapeutic effect, hs-CRP, hemodynamics and changes of heart rhythm were compared between the two groups.Results Hematocrit, plasma viscosity, fibrinogen, erythrocyte sedimentation rate, whole blood viscosity under low shear rate, and whole blood viscosity under high shear rate of the study group were significantly lower than those of the conventional group after treatment, and the difference was statistically significant (P<0.05). There was no significant difference between the two groups in QRS wave durations or PR intervals (P>0.05). The QTc interval of the study group was significantly longer than that of the conventional group, and the difference was of statistical significance (P<0.05). The incidence of ventricular premature beats and paroxysmal ventricular tachycardia in the study group was significantly lower than that of the conventional group (P<0.05). The hs-CRP of the study group was significantly lower than that of the conventional group, and the difference was statistically significant (P<0.05). The total effective rate of the study group was 90.16％, significantly higher than 75.41％ in the conventional group (P<0.05).Conclusion Amiodarone hydrochloride tablets are effective in the treatment of patients with coronary heart disease and arrhythmia, which can evidently improve blood viscosity, regulate serum hs-CRP content, and show no obvious adverse effects.