胺碘酮联合美托洛尔在慢性心力衰竭伴室性心律失常患者治疗中的临床双盲对照研究

Clinical Double-blind Controlled Study of Amiodarone Combined with Metoprolol in the Treatment of Patients with Chronic Heart Failure and Ventricular Arrhythmia

目的:研究胺碘酮联合美托洛尔在慢性心力衰竭伴室性心律失常患者治疗中的临床效果,为患者的恢复提供临床指导。方法:选取抚州市中医医院2020年3月-2022年3月接诊的80例慢性心力衰竭伴室性心律失常患者作为研究对象。按照随机数字表法分为研究组和对照组,各40例。对照组采用胺碘酮治疗,研究组采用胺碘酮联合美托洛尔治疗。治疗前及治疗3个月后,比较两组左室舒张末期容积(LVEDV)、左室收缩末期容积(LVESV)、左室射血分数(LVEF),治疗1、2、3个月后,记录两组窦性心律维持率,治疗3个月后,记录两组的治疗总有效率和不良反应发生情况。结果:研究组总有效率为92.5%,明显高于对照组的72.5%,差异有统计学意义(P<0.05)。治疗前,两组LVEDV、LVESV、LVEF比较,差异均无统计学意义(P<0.05);治疗3个月后,两组LVEDV、LVESV均明显降低,研究组分别为(131.3±30.6)、(67.3±18.4)mL,明显低于对照组的(149.5±32.5)、(85.4±19.8)mL,LVEF明显升高,研究组为(48.7±6.4)%,明显高于对照组的(42.9±5.7)%,差异均有统计学意义(P<0.05)。治疗1、2、3个月后,研究组窦性心律维持率分别为77.5%、87.5%、90.0%,均明显高于对照组的47.5%、60.0%、62.5%,差异均有统计学意义(P<0.05)。两组不良反应发生率分别为5.0%、10.0%,差异无统计学意义(P>0.05)。结论:胺碘酮联合美托洛尔治疗慢性心力衰竭伴室性心律失常效果显著,可有效改善患者心功能,维持患者窦性心律,安全性高。

Objective:To study the clinical effect of Amiodarone combined with Metoprolol in the treatment of patients with chronic heart failure and ventricular arrhythmia,and to provide clinical guidance for the recovery of patients.Method:A total of 80 patients with chronic heart failure and ventricular arrhythmia who were admitted to Fuzhou Hospital of Traditional Chinese Medicine from March 2020 to March 2022 were selected as the research subjects.The patients were divided into a study group and a control group according to the random number table method,with 40 cases in each group.The control group was treated with Amiodarone,and the study group was treated with Amiodarone combined with Metoprolol.Before and after treatment for 3 months,the left ventricular end diastolic volume(LVEDV),left ventricular end systolic volume(LVESV)and left ventricular ejection fraction(LVEF)were compared between the two groups.After treatment for 1 month,2 and 3 months,the sinus rhythm maintenance rate of the two groups were recorded.After treatment for 3 months,the total effective rate and adverse reactions of the two groups were recorded.Result:The total effective rate of the study group was 92.5%,which was significantly higher than 72.5%of the control group,the difference was statistically significant(P<0.05).Before treatment,there were no significant differences in LVEDV,LVSV and LVEF between the two groups(P<0.05).After 3 months of treatment,LVEDV and LVSV in the two groups were significantly decreased,and those in the study group respectively was(131.3±30.6),(67.3±18.4)mL,which were significantly lower than those in the control group(149.5±32.5),(85.4±19.8)mL,LVEF in the study group was significantly increased,and that in the study group group was(48.7±6.4)%,which was significantly higher than(42.9±5.7)%that of the control group,the differences were statistically significant(P<0.05).After 1,2 and 3 months of treatment,the sinus rhythm maintenance rate in the study group respectively was 77.5%,87.5%and 90.0%,which were significantly higher than 47.5%,60.0%and 62.5%in the control group,the differences were statistically significant(P<0.05).The incidence of adverse reactions in the two groups respectively was 5.0%and 10.0%,the difference was not statistically significant(P>0.05).Conclusion:Amiodarone combined with Metoprolol in the treatment of chronic heart failure with ventricular arrhythmia has a significant effect,it can effectively improve the cardiac function of patients,maintain the sinus rhythm of patients,and has high safety.