美托洛尔联合胺碘酮治疗心房颤动合并心力衰竭的临床效果

Clinical effect of metoprolol combined with amiodarone in the treatment of atrial fibrillation complicated with heart failure

目的观察美托洛尔联合胺碘酮治疗心房颤动合并心力衰竭的临床效果。方法回顾性选取2020年1—12月中国人民解放军联勤保障部队第九二一医院收治的心房颤动合并心力衰竭患者56例,根据治疗方法不同分为研究组和参照组,各28例,参照组给予胺碘酮治疗,研究组给予美托洛尔联合胺碘酮治疗,2组患者均治疗8周。比较2组患者临床疗效,治疗前后心功能指标[6 min步行距离(6MWD)、左室射血分数(LVEF)、左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)]、血清炎性因子[肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)、降钙素原(PCT)、白介素-6(IL-6)]水平及不良反应。结果研究组患者总有效率为96.43%,高于参照组的75.00%(χ^(2)=5.250,P=0.022)。治疗8周后,2组患者6MWD、LVEF高于治疗前,LVEDD及LVESD均小于治疗前,且研究组高/小于参照组(P<0.01);2组患者血清TNF-α、CRP、PCT及IL-6水平均较治疗前降低,且研究组低于参照组(P<0.01)。研究组与参照组患者不良反应总发生率比较差异无统计学意义(7.14%vs.10.71%,χ^(2)=0.219,P=0.639)。结论美托洛尔联合胺碘酮治疗心房颤动合并心力衰竭可提升临床效果,改善患者心功能、炎性因子指标水平,值得临床应用。

Objective To observe the clinical effect of metoprolol combined with amiodarone in the treatment of atrial fibrillation complicated with heart failure.Methods The clinical data of 56 patients with atrial fibrillation complicated with heart failure admitted to the 921 Hospital of the Joint Service Support Force of the Chinese People′s Liberation Army from January to December 2020 were retrospectively selected,according to different treatment methods,they were divided into study group and reference group,28 cases in each group.The reference group was treated with amiodarone,and the study group was treated with metoprolol combined with amiodarone,both groups were treated for 8 weeks.The clinical effect,the changes of cardiac function indexes(6MWD,LVEF,LVEDD and LVESD),serum inflammatory factors(TNF-α,CRP,PCT,IL-6)before and after treatment and the occurrence of adverse reactions were compared between the two groups.Results The total effective rate of the study group was 96.43%,which was higher than 75.00%of the reference group(χ^(2)=5.250,P=0.022).After 8 weeks of treatment,6MWD and LVEF of the two groups were higher than those before treatment,LVEDD and LVESD were lower than those before treatment,and the above indexes of the study group were higher or lower than those of the reference group(P<0.01).The serum levels of TNF-α,CRP,PCT and IL-6 in the two groups were lower than those before treatment,and the above indexes of the study group were lower than those of the reference group(P<0.01).There was no significant difference in the total incidence of adverse reactions between the study group and the reference group(7.14%vs.10.71%,χ^(2)=0.219,P=0.639).Conclusion Metoprolol combined with amiodarone in the treatment of atrial fibrillation complicated with heart failure can improve the clinical effect,while improving the cardiac function and inflammatory factors levels of patients,which is worthy of clinical application.