酒石酸美托洛尔联合小剂量胺碘酮治疗心肌梗死后室性心律失常的临床疗效及患者心电图变化分析

Clinical effect of metoprolol tartrate combined with lowdose amiodarone in the treatment of ventricular arrhythmia after myocardial infarction and analysis of electrocardiogram changes in patients

目的探究酒石酸美托洛尔联合小剂量胺碘酮治疗心肌梗死后室性心律失常的临床疗效及患者心电图变化。方法选取2019年4月至2020年4月本院收治的76例心肌梗死后室性心律失常患者作为研究对象,随机分为基础组和分析组,每组38例。基础组给予美托洛尔治疗,分析组给予美托洛尔联合小剂量盐酸胺碘酮治疗,比较两组临床疗效、心电图指标、肌酸激酶同工酶(CK-MB)及B型脑钠肽(BNP)水平、不良反应发生情况。结果分析组治疗总有效率(86.84%)高于基础组(68.42%),差异有统计学意义(P<0.05)。分析组心率(HR)、QRS波时限均低于基础组,P-R间期高于基础组,差异有统计学意义(P<0.05)。分析组CK-MB、BNP水平均低于基础组,差异有统计学意义(P<0.05)。分析组不良反应发生率(5.26%)低于基础组(13.16%),但组间比较差异无统计学意义。结论酒石酸美托洛尔联合小剂量胺碘酮治疗心肌梗死后室性心律失常效果显著,能明显改善患者HR及心功能,降低血浆CK-MB及BNP水平,安全性较高,值得临床推广应用。

Objective To explore the clinical effect of metoprolol tartrate combined with lowdose amiodarone in the treatment of ventricular arrhythmia after myocardial infarction and the changes of electrocardiogram in patients.Methods A total of 76 patients with ventricular arrhythmia after myocardial infarction who were admitted to our hospital from April 2019 to April 2020 were selected as the research subjects,and they were randomly divided into basic group and analysis group,with 38 cases in each group.The basic group was treated with metoprolol tartrate,and the analysis group was treated with metoprolol tartrate combined with lowdose amiodarone,the clinical efficacy,electrocardiogram indexes,levels of creatine kinase MB(CK-MB),B type brain natriuretic peptide(BNP),and adverse reactions were compared between the two groups.Results The total effective rate of treatment in the analysis group(86.84%)was higher than that in the basic group(68.42%),and the difference was statistically significant(P<0.05).The time duration of heart rate(HR)and QRS wave in the analysis group was lower than that in the basic group,and the P-R interval was higher than that in the basic group,and the differences were statistically significant(P<0.05).The levels of CKMB and BNP in the analysis group were lower than those in the basic group,and the differences were statistically significant(P<0.05).The incidence of adverse reactions in the analysis group(5.26%)was lower than that in the basic group(13.16%),but there was no significant difference between the two groups.Conclusion Metoprolol tartrate combined with low-dose amiodarone has significant effect in the treatment of ventricular arrhythmia after myocardial infarction,can significantly improve the HR and cardiac function,and reduce the levels of plasma CK-MB and BNP,and has high safety,it is safe and worthy of clinical application.