胺碘酮缩短疗程方案对老年室性心律失常患者QT间期及QT离散度的影响  

Effects of amiodarone shortening course of treatment on QT interval and QT dispersion in elderly patients with ventricular arrhythmia

作　　者：彭维 陈海英 PENG Wei;CHEN Haiying(Changde Hospital,Xiangya School of Medicine,Central South University(the First People's Hospital of Changde City),Changde 415000,China)

机构地区：[1]中南大学湘雅医学院附属常德医院(常德市第一人民医院),湖南常德415000

出　　处：《临床医学研究与实践》2025年第12期42-45,共4页Clinical Research and Practice

基　　金：湖南省卫生健康委卫生科研课题(No.202203012786)。

摘　　要：目的探讨胺碘酮缩短疗程方案对老年室性心律失常患者QT间期及QT离散度(QTd)的影响。方法采用真实世界研究方法,回顾性分析2018年1月至2024年3月在我院接受胺碘酮治疗的518例老年室性心律失常患者(年龄≥60岁)病历资料和随访数据,按照治疗方案不同将其分为试验组(n=259)和对照组(n=259)。试验组采用缩短疗程方案,对照组采用标准疗程方案。比较两组不同时间的QT间期、心率校正的QT间期(QTc)、QTd、心率校正的QT离散度(QTcd)及临床疗效。结果纳入的518例老年室性心律失常患者中,有69例因各种原因退出研究,最终完成研究449例(试验组254例,对照组195例)。治疗第5、7、10、14、21、30天,试验组的QTc略短于对照组,但差异无统计学意义(P>0.05)。两组出院后1个月的治疗有效率比较,差异无统计学意义(P=0.207)。结论胺碘酮缩短疗程方案能降低老年室性心律失常患者QT间期延长风险,不显著增加QTd,可提高心电活动稳定性,降低恶性心律失常发生率。Objective To investigate the effects of amiodarone shortening course of treatment on QT interval and QT dispersion(QTd)in elderly patients with ventricular arrhythmia.Methods The medical records and follow-up data of 518 elderly patients with ventricular arrhythmia(age≥60 years old)who received amiodarone treatment in our hospital from January 2018 to March 2024 were retrospectively analyzed by real world research method.According to different treatment schemes,the patients were divided into experimental group(n=259)and control group(n=259).The experimental group was treated with shortened course of treatment,and the control group was treated with standard course of treatment.The QT interval,heart rate-corrected QT interval(QTc),QTd,heart rate-corrected QT dispersion(QTcd)at different time points and clinical effect were compared between the two groups.Results Among the 518 elderly patients with ventricular arrhythmias,69 patients withdrew from the study for various reasons,and 449 patients(254 patients in the experimental group and 195 patients in the control group)completed the study.On the 5 th,7 th,10 th,14 th,21 st and 30 th day of treatment,the QTc of the experimental group was slightly lower than that of the control group,but the difference was not statistically significant(P>0.05).There was no significant difference in the effective rate of treatment between the two groups at 1 month after discharge(P=0.207).Conclusion Amiodarone shortening course of treatment can reduce the risk of QT interval prolongation in elderly patients with ventricular arrhythmia,and does not significantly increase QTd.It can improve the stability of ECG activity,and reduce the incidence of malignant arrhythmia.

关 键 词：胺碘酮 室性心律失常 QT间期 QT离散度 

分 类 号：R541.7[医药卫生—心血管疾病]