胺碘酮联合美托洛尔治疗慢性心力衰竭合并心律失常的效果

Effect of Amiodarone Combined with Metoprolol in the Treatment of Chronic Heart Failure Complicated with Arrhythmia

目的:探讨胺碘酮联合美托洛尔治疗慢性心力衰竭合并心律失常的效果。方法:选取2021年1月—2022年1月即墨区第二人民医院收治的慢性心力衰竭合并心律失常患者70例为研究对象,根据随机数字表法分为对照组与研究组,各35例。对照组采用胺碘酮治疗,研究组在对照组基础上采用美托洛尔治疗。比较两组患者心律失常改善效果、心功能指标、心室重构功能指标、血管紧张素和脑钠肽水平、生活质量、不良反应发生率。结果:研究组心律失常发作次数少于对照组,QRS波时间短于对照组,差异有统计学意义(P<0.001);治疗后,研究组左心室舒张末期内径、左心室收缩末期内径小于对照组,左心室射血分数、每搏输出量高于对照组,差异有统计学意义(P<0.001);治疗后,研究组左室内径缩短率、室壁增厚率、室间隔运动幅度高于对照组,差异有统计学意义(P<0.05);治疗后3、5d,研究组血管紧张素和脑钠肽水平均低于对照组,差异有统计学意义(P<0.001);治疗后,研究组躯体功能、精神面貌、社会功能、生活能力评分高于对照组,差异有统计学意义(P<0.001);研究组不良反应发生率低于对照组,差异有统计学意义(P=0.040)。结论:胺碘酮联合美托洛尔治疗慢性心力衰竭合并心律失常的效果确切,对于改善患者心功能和症状有积极作用,提高患者生活质量,减少不良反应。

Objective:To investigate the effect of amiodarone combined with metoprolol in the treatment of chronic heart failure complicated with arrhythmia.Methods:Seventy patients with chronic heart failure complicated with arrhythmia admitted to Jimo District Second People's Hospital from January 2021 to January 2022 were selected as the study objects,and were divided into control group and study group according to random number table method,with thirty-five cases in each group.The control group was treated with amiodarone,and the study group was treated with metoprolol based on the control group.The improvement effect of arrhythmia,cardiac function index,ventricular remodeling function index,angiotensin and brain natriuretic peptide levels,quality of life and incidence of adverse reactions were compared between the two groups.Results:The frequency of arrhythmia in the study group was less than that in the control group,and the duration of QRS wave was shorter,the difference was statistically significant(P<0.001);After treatment,left ventricular end-diastolic diameter and left ventricular end-systolic diameter in the study group were smaller than those in the control group,and left ventricular ejection fraction and stroke output were higher than those in the control group,with statistical significance(P<0.001);After treatment,the left ventricular diameter shortening rate,ventricular wall thickening rate and interventricular septal motion amplitude in the study group were higher than those in the control group,and the differences were statistically significant(P<0.05);On 3 and 5 days after treatment,the levels of angiotensin and brain natriuretic peptide in the study group were lower than those in the control group,and the difference was statistically significant(P<0.001);After treatment,the scores of physical function,mental outlook,social function and life ability of the study group were higher than those of the control group,and the differences were statistically significant(P<0.001);The incidence of adverse reactions in study group was lower than that in control group,and the difference was statistically significant(P=0.040).Conclusion:Amiodarone combined with metoprolol is effective in the treatment of chronic heart failure complicated with arrhythmia,and has positive effects on improving cardiac function and symptoms,improving patients'quality of life and reducing adverse reactions.