心可舒片治疗冠心病频发室性早搏患者的临床研究

Clinical trial of Xinkeshu tablets in the treatment of coronary heart disease patients with frequent premature ventricular contractions

目的观察心可舒片治疗冠心病频发室性早搏的疗效,并探讨其对患者QT离散度、心率变异性的影响。方法将100例冠心病频发室性早搏患者随机分为试验组和对照组,各50例。对照组进行常规治疗,试验组在对照组的基础上给予心可舒片,每次1.24 g,每天3次。2组患者均治疗4周。观察2组患者治疗前后早搏发生数,测量治疗前后QT间期,计算QT离散度指标;同时检测患者心率变异性相关指标。结果治疗后,试验组和对照组的总有效率分别为88.00%和72.00%,差异有统计学意义(P<0.05)。治疗后,对照组与试验组QTm分别为(410.30±39.77)和(438.90±43.23)ms;QTcm分别为(462.30±44.65)和(482.80±46.51)ms;QTd分别为(45.30±4.23)和(33.80±4.98)ms;QTcd分别为(51.70±4.53)和(36.60±5.12)ms;R-R间期标准差(SDNN)分别为(108.50±18.79)和(127.40±21.34)ms。治疗后2组患者QTm、QTcm较治疗前显著延长,2组患者QTd、QTcd较治疗前缩短,2组患者SDNN、每5 min平均正常的R-R间期标准差(SDANN)、相邻正常R-R间期差值均方根(RMSSD)和相邻正常R-R间期差值≥50 ms心搏数占总R-R间期数比例(PNN50)较治疗前升高,且2组间上述指标差异均有统计学意义(均P<0.05)。试验组不良心脏事件发生率(8.00%)较对照组(22.00%)显著降低(P<0.05)。结论心可舒片治疗冠心病频发室性早搏的临床疗效较好,能有效改善患者的QT离散度和心率变异性,改善患者的心脏自主功能活动。

Objective To observe the effect of Xinkeshu tablets in the treatment of coronary heart disease patients with frequent premature ventricular contractions,and explore its effect on QT dispersion and heart rate variability of patients.Methods A total of 100 coronary heart disease patients with frequent premature ventricular contractions were randomly divided into treatment group and control group,with 50 cases in each group.Control group was given routine treatment,treatment group was given Xinkeshu tablets 1.24 g per time,3 times per day on the basis of control group.The treatment period was 4 weeks of the two groups.The number of premature beats before and after treatment was observed in two groups.The QT interval was measured before and after treatment,and the QT dispersion index was calculated.The heart rate variability related indicators were also detected.Results After treatment,the effective rates of treatment group and control group were 88.00%,72.00%,with significant difference(P<0.05).After treatment,the QTm in control group and treatment group were(410.30±39.77),(438.90±43.23)ms;QTcm were(462.30±44.65),(482.80±46.51)ms;QTd were(45.30±4.23),(33.80±4.98)ms;QTcd were(51.70±4.53),(36.60±5.12)ms;the standard deviation of NN intervals(SDNN)were(108.50±18.79),(127.40±21.34)ms.The QTm,QTcm in two groups were extended compared with before treatment,the QTd,QTcd in two groups were shortened compared with before treatment,the SDNN,standard deviation of the average R-R intervals calculated every five minutes(SDANN),the square root of the mean of the squared differences between adjacent normal RR intervals(RMSSD)and between adjacent R-R period more than 50 ms percentage(PNN50)in two groups were increased compared with before treatment,and the above indexes between the two groups had significant difference(all P<0.05).The incidence of adverse cardiac events in treatment group(8.00%)was significantly lower than that(22.00%)in control group(P<0.05).Conclusion Xinkeshu tablets are effective in the treatment of frequent ventricular premature beats in coronary heart disease.It can effectively improve the patient’s QT dispersion and heart rate variability and improve the patient’s cardiac autonomic activity.