酒石酸美托洛尔联合胺碘酮治疗冠心病伴快速性心律失常患者的临床疗效及其安全性

Clinical efficacy and safety of metoprolol tartrate combined with amiodarone in the treatment of coronary heart disease with tachyarrhythmia

目的观察酒石酸美托洛尔联合胺碘酮治疗冠心病伴快速性心律失常患者的临床疗效及其安全性。方法选取2019—2020年湖南省职业病防治院收治的冠心病伴快速性心律失常患者80例,按照随机数字表法分为常规组与观察组,各40例。常规组患者予以酒石酸美托洛尔片,观察组患者在常规组治疗基础上联合盐酸胺碘酮片。2组患者均持续治疗1个月。比较2组临床疗效,治疗前后心电图指标(QT离散度、QRS波时限变化)、心功能指标[左心室射血分数(LVEF)、左心室收缩末期内径(LVESD)、左心室收缩末期容量(LVESV)、左心室舒张末期容量(LVEDV)],不良反应发生率。结果观察组患者治疗总有效率为97.50%,高于常规组的82.50%(χ^(2)=5.000,P=0.025)。治疗1个月后,2组QT离散度、QRS波时限变化低于治疗前,且观察组低于常规组(P<0.01)。治疗1个月后,2组LVEF、LVESV及LVEDV高于治疗前,LVESD低于治疗前,且观察组LVEF、LVESV及LVEDV高于常规组,LVESD低于常规组(P<0.01)。2组低血压、心动过缓、胸痛发生率比较,差异无统计学意义(P>0.05)。结论酒石酸美托洛尔联合胺碘酮可提高冠心病伴快速性心律失常患者临床疗效,有效改善心功能,且不会增加不良反应发生率。

Objective To observe the clinical efficacy and safety of metoprolol tartrate combined with amiodarone in the treatment of coronary heart disease with tachyarrhythmia.Methods A total of 80 cases of patients with coronary heart disease with tachyarrhythmia.Results A total of 80 cases of patients with coronary heart disease with tachyarrhythmia were selected from 2019 to 2020 year in Hunan Prevention And Treatment Institute For Occupational Diseases,which were divided into routine group and observation group,with 40 cases in each group according to the random number method.The routine group was treated with metoprolol tartrate tablets,and the observation group was treated with amiodarone hydrochloride tablets on the basis of the routine group.Both groups were treated for 1 month.Clinical efficacy,ECG indexes(QT dispersion,QRS wave duration changes),cardiac function indexes(LVEF,LVESD,LVESV,LVEDV)before and after treatment,and incidence of adverse reactions were compared between the two groups.Results The total effective rate of the observation group was 97.50%,higher than 82.50%of the routine group(χ^(2)=5.000,P=0.025).After treatment,the changes of QT dispersion and QRS wave time limit in the two groups were lower than those before treatment,and those in the observation group were lower than the routine group(P<0.01).After treatment,LVEF,LVESV and LVEDV in the two groups were higher than those before treatment,LVESD was lower than that before treatment,and LVEF,LVESV,LVEDV in the observation group were higher than those in the routine group,and LVESD was lower than that in the routine group(P<0.01).There was no significant difference in the incidence of hypotension,bradycardia and chest pain between the two groups(P>0.05).Conclusion Metoprolol tartrate combined with amiodarone can improve the clinical efficacy of patients with coronary heart disease with tachyarrhythmia,effectively improve cardiac function,and will not increase the incidence of adverse reactions.