胺碘酮禁忌型ACS伴急性心律失常患者瑞舒伐他汀治疗的临床研究

Clinical study of rosuvastatin in patients with amiodarone contraindi-cated ACS with acute arrhythmia

目的探讨胺碘酮禁忌型急性冠脉综合征(ACS)伴急性心律失常患者行瑞舒伐他汀治疗的临床疗效。方法选取2017年4月—2019年4月四川省隆昌市人民医院收治的胺碘酮禁忌型ACS伴急性心律失常患者作为研究对象。共110例。按照双盲随机数字表法将患者分成两组,对照组55例行溶栓、低分子肝素和瑞舒伐他汀治疗,观察组55例在对照组治疗基础上加用美托洛尔治疗。对比两组患者心脏功能、炎性因子和氧化应激指标变化情况,评估两组患者的疗效。结果连续治疗8周后,观察组总有效率为96.36%,对照组为85.45%,差异有统计学意义(χ^(2)=3.960,P=0.047)。治疗前两组患者24 h R-R间期标准差(SDNN)、相邻正常R-R间期差值均方根值(rMSSD)无明显差异;治疗后观察组SDNN、rMSSD均显著大于对照组(P<0.05)。治疗后观察组血清肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)低于对照组,超氧化物歧化酶(SOD)高于对照组、丙二醛(MDA)低于对照组(P<0.05)。结论胺碘酮禁忌型ACS伴急性心律失常患者使用美托洛尔治疗疗效显著,可更好地消除机体炎性因子和自由基,改善心肌功能。

Objective To investigate the clinical efficacy of rosuvastatin in patients with amiodarone contraindicated acute coronary syndrome(ACS)with acute arrhythmia.Methods A total of 110 patients with amiodarone contraindica⁃tion ACS and acute arrhythmia admitted to our hospital from April 2017 to April 2019 were enrolled in the study.TDi⁃vided into two groups according to the double-blind random number method,55 patients in the control group were treat⁃ed with thrombolysis,low-molecular-weight heparin and rosuvastatin,and 55 patients in the observation group were treated with metoprolol in addition to the control group.Changes in cardiac function,inflammatory factors,and oxida⁃tive stress indicators were evaluated for the efficacy of the two groups of patients.Results After 8 weeks of continuous treatment,the total effective rate in the observation group was 96.36%,and that in the control group was 85.45%,with statistically significant difference(χ^(2)=3.960,P=0.047).The difference of 24h RR interval standard(SDNN)and adja⁃cent normal RR interval between the two groups before treatment.There was no significant difference in root mean square value(rMSSD).After treatment,the SDNN and rMSSD in the observation group were significantly higher than those in the control group(P<0.05).After treatment,the serum tumor necrosis factor-α(TNF-α)and high-sensitivity C-reactive protein.(hs-CRP)were lower than those in the control group,superoxide dismutase(SOD)was higher than than in the control group,and malondialdehyde(MDA)was lower than that in the control group(P<0.05).Conclusion The use of metoprolol in patients with amiodarone contraindicated ACS with acute arrhythmia has a significant effect,which can better eliminate inflammatory factors and free radicals and improve myocardial function.