小剂量索他洛尔和美托洛尔治疗肥厚型心肌病伴恶性室性心律失常的疗效观察

Effect of small dose of sotalol and metoprolol on hypertrophic cardiomyopathy accompanied with malignant ventricular arrhythmia

目的观察小剂量索他洛尔和美托洛尔(倍他乐克)联合治疗肥厚型心肌病伴恶性室性心律失常的疗效。方法对36例肥厚型心肌病伴恶性心律失常的患者,给予索他洛尔和美托洛尔口服治疗,并对心率、QT间期最大值、QT间期最小值和QT间期离散度进行治疗前后的测量。结果治疗后,总有效率为75%,心率由基础的(84.5±5.4)次/min降至(66.5±8.3)次/min(P<0.01),QT间期最大值由治疗前的(411±34)ms延长到治疗后的(415±41)ms(P>0.05),QT间期最小值由治疗前(313±32)ms延长至(353±42)ms(P<0.01),QT间期离散度由治疗前(95±31)ms缩小至(63±20)ms(P<0.01)。无心功能恶化,不良反应轻微。结论本方法疗效确切、方便、安全,无明显致心律失常作用,值得临床推广应用。

Objective： To observe the effect of small dose of sotalol plus metoprolol on hypertrophic cardiomyopathy accompanied with malignant ventricular arrhythmia. Methods： Thirty six patients with hypertrophic cardiomyopathy accompanied with malignant ventricular arrhythmia were given sotalol plus metoprolol （ small dosage ） orally. The heart rate, QTmax interval, QTmin interval and QT division were recorded before and after treatment. Results： The total response rate was 75 %. Heart rate decreased from （84.5 ± 5.4 ） beat/min to （66.5 ± 8.3 ） beat/min （ P 〈 0.01 ）. The QTmax interval increased from （411 ±34） ms to （415 ±41） ms （P〉0.05）. The QTmin interval increased from （313 ±32） ms to （353±42） ms （P〈0.01）. QT division decreased from （95±31） ms to （63±20） ms （P〈0.01）. The heart function was not aggravated. The adverse reaction was slight. Conclusion ： Sotalol plus metoprolol （ small dosage ）is effective and safe and do not cause apparent arrhythmia. It is worthy of clinical application.