摘要:目的:探讨胺碘酮治疗充血性心力衰竭(CHF)心房颤动伴快速心室率的临床疗效。方法: 将106例各种原因所致的房颤伴快速心室率的CHF患者按入院顺序随机分为治疗组及对照组。两组抗CHF基础治疗相同,治疗组加用静脉负荷量胺碘酮150 mg后,再以1 000μg/min静脉点滴维持6小时,500 μg/min静滴18小时。同时口服胺碘酮0.2,3次/d,1周;再0.2,2次/d,1周以后以0.2,1次/d 至观察终点,随诊为12个月。 结果: 治疗组53例使用胺碘酮治疗可显著增加抗心律失常有效性,改善左室射血分数,减少心力衰竭再住院率,42例患者转复为室性心律。 结论: 静脉及口服胺碘酮同时应用治疗充血性心力衰竭房颤是有效和安全的。Abstract: Objective: To explore the effect and safety of amiodarone in the treatment of atrial fibrillation with congestive heart failure. Methods:One hundred and six patients of AF with CHF caused by a variety of reasons were randomly divided into treatment group and control group according to hospitalized order.The two groups were treated with the same antiCHF therapy,the treatment group was treated with loaded intravenous amiodarone 150 mg;and then dripped to 1 000 μg/min for 6 hours, dripped to 500 μg/min for 18 hours. United with oral amiodarone by amiodarone tablets with 0.2 g,3 time/day a week,further 0.2 g,2 times/day a week,later 0.2 g,1 times/day to the end.The end of followup time was 12 months. Results:In treatment group,53 cases with amiodarone therapy can significantly increase the effectives of antiarrhythmic, improve the rate and heart failure rehospitalization.42/53 patients reversed to sinus rhythm. Conclusion:The results showed it is effective and safe united with intravenous amiodarone and oral amiodarone in treatment of atrial fibrillation with organic heart disease.
The analysis parameters for the characterization of heart rate variability (HRV) within a very short time (＜1 min) usually exhibit complicate variation patterns over time, which may easily interfere the judgment to the status of the cardiovascular system. In this study, long-term HRV sequence of 41 cases of healthy people (control group) and 25 cases of congestive heart failure (CHF) patients (experimental group) was divided into multiple segments of very short time series. The variation coefficient of the same HRV parameter under multiple segments of very short time series and the testing proportion with statistically significant differences under multiple interclass t-test were calculated. On this account, part of HRV analysis parameters under very short time were discussed to reveal the stability of difference of the cardiovascular system function under different status. Furthermore, with analyzing the receiver operating characteristic (ROC) curve and modeling the artificial neural network (ANN), the classification effects of these parameters between the control group and the experimental group were assessed. The results demonstrated that ① the indices of entropy of degree distribution based on the complex network analysis had a lowest variation coefficient and was sensitive to the pathological status (in 79.75% cases, there has statistically significant differences between the control group and experimental group), which can be served as an auxiliary index for clinical doctor to diagnose for CHF patient; ② after conducting ellipse fitting to Poincare plot, in 98.5% cases, there had statistically significant differences for the ratio of ellipse short-long axis (SDratio) between the control group and the experimental group; when modeling the ANN and solely adopting SDratio, the classification accuracy to the control group and experimental group was 71.87%, which demonstrated that SDratio might be acted as the intelligent diagnosis index for CHF patients; ③ however, more sensitive and robust indices were still needed to find out for the very-short HRV analysis and for the diagnosis of CHF patients as well.