胺碘酮联合美托洛尔治疗慢性心力衰竭合并室性心律失常的疗效及安全性分析

Analysis of efficacy and safety of amiodarone combined with metoprolol in the treatment of chronic heart failure complicated with ventricular arrhythmia

目的 分析应用胺碘酮联合美托洛尔治疗慢性心力衰竭合并室性心律失常的疗效及安全性。方法 70例慢性心力衰竭合并室性心律失常患者,依据随机数字表法分为单独用药组与复合用药组,每组35例。单独用药组采用胺碘酮治疗,复合用药组在对照组基础上加用美托洛尔治疗。比较两组治疗前后心率(HR)、PR间期、QT离散度(QTd)、校正QT离散度(QTcd)、左心室射血分数、血清C反应蛋白、脑钠肽水平及治疗效果、不良反应发生情况。结果 治疗后,两组HR、PR间期、QTd、QTcd、左心室射血分数、血清C反应蛋白、脑钠肽水平均优于本组治疗前,且复合用药组HR(65.21±2.61)次/min、QTd(50.12±2.01)ms、QTcd(51.16±2.01)ms、血清C反应蛋白(6.44±1.21)mg/L、脑钠肽(78.45±2.67)pg/ml均显著低于单独用药组的(75.01±4.52)次/min、(67.56±3.10)ms、(67.21±4.12)ms、(8.21±1.42)mg/L、(88.21±11.27)pg/ml, PR间期(467.50±84.12)ms、左心室射血分数(57.01±4.21)%显著高于单独用药组的(397.45±56.12)ms、(53.01±4.01)%,差异均有统计学意义(P<0.05)。复合用药组治疗总有效率94.29%高于单独用药组的74.29%,差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论 美托洛尔联合胺碘酮治疗慢性心力衰竭合并室性心律失常效果确切,可有效改善患者的心功能,纠正心力衰竭,且可改善血液学指标,安全性高,值得推广和应用。

Objective To analyze the efficacy and safety of amiodarone combined with metoprolol in the treatment of chronic heart failure complicated with ventricular arrhythmia. Methods A total of 70 patients with chronic heart failure and ventricular arrhythmias were divided into a single drug group and a combined drug group according to the random numerical table, with 35 patients in each group. The single drug group was treated with amiodarone, and the combined drug group was treated with metoprolol on the basis of the control group. Both groups were compared in terms of heart rate(HR), PR interval, QT dispersion(QTd), corrected QT dispersion(QTcd), left ventricular ejection fraction, serum C-reactive protein and brain natriuretic peptide level before and after treatment, therapeutic effect, and occurrence of adverse reactions. Results After treatment, the HR, PR interval, QTd, QTcd, left ventricular ejection fraction, serum C-reactive protein, and brain natriuretic peptide levels in both groups were better than those before treatment in this group;the HR(65.21±2.61) beats/min,QTd(50.12±2.01) ms, QTcd(51.16±2.01) ms, serum C-reactive protein(6.44±1.21) mg/L, and brain natriuretic peptide(78.45±2.67) pg/ml in the combined drug group were significantly lower than(75.01±4.52) beats/min,(67.56±3.10) ms,(67.21±4.12) ms,(8.21±1.42) mg/L,(88.21±11.27) pg/ml in the single drug group;the PR interval(467.50±84.12) ms, left ventricular ejection fraction(57.01±4.21)% in the combined drug group were significantly higher than(397.45±56.12) ms,(53.01±4.01)% in the single drug group;All differences were statistically significant(P<0.05). The total effective rate of treatment was 94.29% in the combined drug group, which was higher than 74.29% in the single drug group, and the difference was statistically significant(P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05). Conclusion Metoprolol combined with amiodarone is effective in the treatment of chronic heart failure complicated with ventricular arrhythmia, and can effectively improve the heart function of patients, correct heart failure, and improve the hematology index. It has high safety, and is worthy of promotion and application.