二丁酰环磷腺苷钙联用琥珀酸美托洛尔治疗心力衰竭合并心律失常的疗效

Effect of calcium dibutyacyladenosine cyclophosphate combined with metoprolol succinate for heart failure complicated with arrhythmia and its influence on NT-proBNP level

目的 观察二丁酰环磷腺苷钙联用琥珀酸美托洛尔治疗心力衰竭合并心律失常的疗效及对氨基末端脑钠肽前体(NT-proBNP)水平的影响。方法 回顾性选取2019年1月—2020年12月安陆市普爱医院收治的心力衰竭合并心律失常患者112例为研究对象,根据治疗方法不同分为甲组(n=52)与乙组(n=60)。2组均行常规治疗,甲组予以琥珀酸美托洛尔缓释片,乙组予以琥珀酸美托洛尔片联合注射用二丁酰环磷腺苷钙。2组均治疗2个月。比较2组临床疗效,治疗前后NT-proBNP、心率变异性指标[包括全部窦性心搏RR间期标准差(SDNN)、RR间期平均标准差(SDANN)、相邻RR间期差值均方根(rMSSD)]、心功能指标[包括左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)],不良反应。结果 乙组总有效率为98.33%,高于甲组的88.46%(χ^(2)=4.633,P=0.031)。治疗2个月后,2组血清NT-proBNP水平低于治疗前,且乙组低于甲组(P<0.01)。治疗2个月后,2组SDNN、SDANN、rMSSD高于治疗前,且乙组高于甲组(P<0.01)。治疗2个月后,2组LVEF高于治疗前,LVEDD、LVESD小于治疗前,且乙组升高/减小幅度大于甲组(P<0.05)。2组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论 二丁酰环磷腺苷钙联用琥珀酸美托洛尔治疗心力衰竭合并心律失常的疗效确切,可有效改善心功能,降低NT-proBNP水平,且安全性较高。

Objective To observe the effect of calcium dibutyacyladenosine cyclophosphate combined with metoprolol succinate for heart failure complicated with arrhythmia and its influence on NT-proBNP level.Methods A total of 112 cases of patients with heart failure complicated with arrhythmia were retrospectively selected from January 2019 to December 2020 in Anlu Puai Hospital,which were randomly divided into group A(n=52)and group B(n=60)according to different treatment methods.All patients were treated with conventional drugs,group A was given metoprolol succinate sustained-release tablets,while group B was given metoprolol succinate combined with calcium dibutyacyladenosine cyclophosphate.Both groups were treated for 2 months.Clinical efficacy,NT-proBNP,heart rate variability(SDNN,SDANN,rMSSD),cardiac function indexes(LVEF,LVEDD,LVESD)before and after 2 months of treatment,adverse reactions were compared between the two groups.Results The total effective rate of group B was 98.33%,higher than 88.46%of group A(χ^(2)=4.633,P=0.031).After 2 months of treatment,the serum NT-proBNP in the two groups was lower than that before treatment,and that in group B was lower than group A(P<0.01).After 2 months of treatment,SDNN,SDANN and rMSSD in the two groups were higher than those before treatment,and those in group B were higher than group A(P<0.01).After 2 months of treatment,LVEF in the two groups was higher than that before treatment,LVEDD and LVESD were lower than those before treatment,and the above indexes in group B were better than group A(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion Calcium dibutyacyladenosine cyclophosphate combined with metoprolol succinate have an exact clinical effect for heart failure complicated with arrhythmia,which can effectively improve cardiac function,reduce NT-proBNP level,and has high safety.