美托洛尔对急性心律失常患儿的疗效及对血清心肌酶和炎症因子的影响

Effect of metoprolol on arrhythmia,serum myocardial enzymes and inflammatory factors

目的:分析美托洛尔对急性心律失常患儿的疗效及对血清心肌酶和炎症因子的影响。方法:收集2014年6月至2017年4月我院收治的急性心律失常患儿105例,分为予心肌营养治疗的对照组(51例)和给予美托洛尔治疗的观察组(54例),两组均治疗8周。记录患儿治疗前后心肌酶、炎症因子、心率变异指标、早搏改善情况,并观察比较两组的疗效。结果:治疗后,与对照组比,观察组血清心肌酶肌酸激酶(CK)、乳酸脱氢酶(LDH)、肌酸激酶同工酶(CK-MB)、天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、C-反应蛋白(CRP)、肿瘤坏死因子(TNF-α)、白介素-6(IL-6)、白介素-8(IL-8)明显降低(均P <0.05),窦性心搏RR间期标准差(SDNN)、5 min窦性心搏RR间期标准差均值(SDNNI)、5 min窦性心搏RR间期均值标准差(SDANN)、相邻窦性心搏RR间期差值均方根(RMSSD)及相邻窦性心搏RR间期差值4 h> 50 ms所占比例(PNN50)明显增加(均P <0.05)。两组均无死亡病例。对照组早搏改善人数和临床疗效的总有效人数较观察组多(P <0.05)。不良反应发生率两组差异无统计学意义(P> 0.05),但观察组不良反应有降低趋势。结论:美托洛尔治疗心律失常患儿疗效确切,其作用与降低血清心肌酶和炎症因子有关。

Objective:To investigate the effect of metoprolol on arrhythmia,serum myocardial enzymes and inflammatory factors.Methods:One hundred and five children with arrhythmia admitted in our hospital from June 2014 to April 2017 were enrolled in this study and randomly divided into 2 groups:51 cases was given myocardial nutrition therapy(control group)and 54 cases was given metoprolol(observation group).Both groups had been treated for 8 weeks.Serum myocardium enzymes,inflammatory factors,heart rate variability indicators,premature beat improvement were recorded before and after treatment and efficacy was compared between the two groups.Results:After treatment,compared with the control group,the levels of serum creatine kinase(CK),lactate dehydrogenase(LDH),creatine kinase-MB(CK-MB),alanine aminotransferase(ALT),aspartic transaminase(AST),C-reactiveprotein(CRP),tumor necrosis factorα(TNF-α),interleukin-6(IL-6)and interleukin-8(IL-8)had significantly decreased(all P<0.05),heart rate variability indicators SDNN,SDNNI,SDANN,RMSSD and PNN50 had significantly increased(all P<0.05)in the observation group.There was no deaths in the two groups.The cases of improvement of premature beats and total effective patients in the observation group were more than those in the control group(P<0.05).There was no significant difference of side effectes between the two groups(P>0.05).Conclusion:Metoprolol is effective in the treatment of child arrhythmia,which is related to decreasing of serum myocardial enzymes and inflammatory factors.