重症类风湿心脏病患者应用二尖瓣闭式扩张术结合胺碘酮对增强心脏代偿功能的价值  

Value of Closed Mitral Valve Dilatation Combined with Amiodarone in Enhancing Cardiac Compensatory Function in Patients with Severe Rheumatoid Heart Disease

作　　者：杨莉 关孟梦 赵巧霞 YANG Li;GUAN Meng-meng;ZHAO Qiao-xia(Zhengzhou Seventh People's Hospital,Zhengzhou Henan 450000,China)

机构地区：[1]郑州市第七人民医院,河南郑州450000

出　　处：《药品评价》2020年第6期62-64,共3页Drug Evaluation

基　　金：河南省科技攻关计划项目(编号2018020861)。

摘　　要：目的:探究重症类风湿心脏病患者应用二尖瓣闭式扩张术结合胺碘酮对增强心脏代偿功能的价值。方法:选取2016年11月至2019年11期间我院收治的110例重症类风湿心脏病患者,随机分成对照组(n=45)、观察组(n=65),对照组仅予以二尖瓣闭式扩张手术治疗,观察组予以二尖瓣闭式扩张术联合胺碘酮治疗,比较两组的心脏代偿功能增强效果。结果:两组的FS参数差异无统计学意义(P>0.05);与对照组相比,观察组患者的心脏射血分数(EF)、每搏输出量(SV)及E/A参数明显增高(P<0.05);第2次、3次随访结果为观察组的心脏代偿功能增强率(73.85%)、(92.31%)均明显高于对照组(53.33%)、(62.22%)(P<0.05);治疗前,两组患者的血流动力学指标差异无统计学意义(P>0.05);治疗后,两组的全血比黏度、血浆比黏度、血细胞比积(Hct)及红细胞沉降率(ESR)指标明显低于治疗前,且观察组患者的指标明显低于对照组(P<0.05);观察组的心律失常发生率(3.08%)、治疗失败率(1.54%)均明显低于对照组(11.11%)、(15.56%)(P<0.05)。结论:二尖瓣闭式扩张术联合胺碘酮治疗重症类风湿心脏病患者可进一步增强患者的心功能及心脏代偿功能,促进血流动力学稳定,预后更佳,值得临床推荐。Objective:To explore the value of mitral valve closed dilatation combined with amiodarone in enhancing cardiac compensatory function in patients with severe rheumatoid heart disease.Methods:From November 2016-to November2019110 cases of our hospital during the period of severe rheumatoid heart patients,randomly divided into control group(n=45),the observation group(n=65),the control group only to expansion of mitral valve closed surgery,observation group with mitral valve closed dilatation joint amiodarone treatment,compared two groups of cardiac compensatory function enhancement effect.Results:There was no significant difference in FS parameters between the two groups(P>0.05).Compared with the control group,the EF,SV and E/A parameters of the observation group were significantly higher(P<0.05).At the second and third follow-up,the cardiac compensatory function enhancement rate(73.85%)and(92.31%)of the observation group were significantly higher than those of the control group(53.33%)and(62.22%)(P<0.05).Before treatment,there was no statistically significant difference in hemodynamic indexes between the two groups(P>0.05).After treatment,the whole blood ratio viscosity,plasma ratio viscosity,Hct and ESR indexes of the two groups were significantly lower than those before treatment,and the indexes of the observation group were significantly lower than those of the control group(P<0.05).The incidence of arrhythmia(3.08%)and treatment failure rate(1.54%)in the observation group were significantly lower than those in the control group(11.11%)and(15.56%)(P<0.05).Conclusion:Closed mitral valve dilatation combined with amiodarone in the treatment of patients with severe rheumatoid heart disease can further enhance cardiac function and cardiac compensatory function,promote hemodynamic stability,and have a better prognosis,which is worthy of clinical recommendation.

关 键 词：重症类 风湿心脏病 二尖瓣闭式扩张术 胺碘酮 心脏代偿功能 

分 类 号：R654[医药卫生—外科学]