胺碘酮联合厄贝沙坦对慢性心功能不全合并阵发性房颤的临床效果观察  

Contrast Analysis of Olanzapine Combined with Sodium Valproate on Refractory Schizophrenia

作　　者：张芳[1] 黄东博 解卫春 刘丽霞[1] 唐会元[1] 

机构地区：[1]陕西省西安市公安消防支队卫生队,陕西西安710032

出　　处：《现代生物医学进展》2013年第18期3538-3541,共4页Progress in Modern Biomedicine

基　　金：国家自然科学基金项目(30770823)

摘　　要：目的:评价胺碘酮联合厄贝沙坦治疗慢性心功能不全合并阵发性房颤的临床疗效及安全性。方法:选择我院收治的慢性心衰合并阵发性房颤患者167例,均使用胺碘酮维持窦性心律,根据患者是否加用厄贝沙坦分为治疗组及对照组。治疗一年后,观察和比较两组患者的心衰住院率、左室射血分数、左房内径、心功能分级情况,通过动态心电图评估窦性心律维持率、房颤复发率。结果:治疗后,治疗组房颤的复发率、慢性房颤的发生率均明显低于对照组,窦性心律维持率明显高于对照组,左房内径较对照组明显减小,心衰住院率明显低于对照组,差异均有统计学意义(P<0.05);对照组左房内径较治疗前明显扩大(P<0.05),两组患者在心功能分级方面较治疗前均有明显改善(P<0.05),但两组之间心功能分级比较无统计学差异(P>0.05)。两组不良反应(甲状腺功能异常、肝功能异常、肺纤维化、低血压)的发生率比较无统计学差异(P>0.05)。结论:胺碘酮联合厄贝沙坦治疗慢性心功能不全伴阵发性房颤的患者,能较好的维持窦性心律,降低心衰住院率,对心脏重构有较好的改善作用,且具有良好的安全性。Objective：To investigate the effects of olanzapine combined with sodium valproate on refractory schizophrenia.Methods：Eighty schizophrenia patients were randomly divided into combined group（40cases） and control group（40cases）.The combined group was given olanzapine starting does of 10mg·d-1 to 20 mg·d-1 within 2weeks and sodium valproate at a starting dose of 600 mg·d-1（maximum dose 1200 mg·d-1）.Single drug group was treated only with olanzapine.The treatment course was 8 weeks.Clinical efficacies wes assessed by positive and negative syndrome scale（PANSS）,side effects were assessed by treatment emergent symptom scale（TESS）.The blood concentration of olanzapine was measured at 2nd,4th,8th week after the treatment.Results：At the eighth weekend,two groups with total PANSS before treat after with treat relatively shown the difference of with on significance（P0.05）.Two groups of curative effect had already shown the high difference in total PANSS（P0.001）,positive syndrome（P0.001）,negative syndrome（P0.05）.The scores of TESS between the two groups had no statistical difference.Conclusion：The combined use of olanzapine and sodium valproate can improve curative effect with high safety in the treatment of refractory schizophrenia.

关 键 词：厄贝沙坦 胺碘酮 慢性心功能不全 阵发性房颤 

分 类 号：R541[医药卫生—心血管疾病]