决奈达隆联合美托洛尔应用于老年房性心律失常患者的疗效观察

Efficacy of dronedarone combined with metoprolol on elderly patients with atrial arrhythmia

目的 探讨决奈达隆联合小剂量美托洛尔治疗快速性房性心律失常的疗效。方法 选取2020年1月至2022年1月江苏省苏北人民医院收治的老年快速性房性心律失常患者160例,按照掷币法随机分为决奈达隆组57例、美托洛尔组55例和联合(决奈达隆+美托洛尔)组48例。比较3组用药前后心律失常发作次数、持续时间及症状变化等发生情况。结果 用药3个月和6个月后,联合组总有效率显著高于决奈达隆组和美托洛尔组,差异有统计学意义(P<0.05)。用药6个月后,联合组心房颤动(AF)发作次数[(2.31±1.78)次/48 h vs(11.56±18.68)次/48 h]、AF持续时间[(4.86±6.73)h/48 h vs(10.92±9.61)h/48 h]、心房扑动(AFL)发作次数[(2.33±1.53)次/48 h vs(4.33±1.53)次/48 h],AFL持续时间[(5.15±4.87)h/48 h vs(21.54±20.08)h/48 h]少于用药前,决奈达隆组AFL持续时间[(2.75±1.94)h/48 h vs(10.29±8.04)h/48 h]明显少于用药前,差异有统计学意义(P<0.05)。结论 决奈达隆联合小剂量美托洛尔治疗快速性房性心律失常不仅能明显改善症状,还能显著减少房性期前收缩、房性心动过速发作次数,减少AF、AFL的发作次数及持续时间,可有效控制心率。

Objective To investigate the efficacy of dronedarone combined with low dose metoprol-ol in the treatment of atrial tachycardia.Methods A total of 175elderly patients with atrial tachy-cardia admitted in Northern Jiangsu People's Hospital during January 2020to January 2022were enrolled and then randomly divided into dronedarone group(n=57),metoprolol group(n=55)and combined group(dronedarone+metoprolol,n=48).The frequency,duration and symptom changes of arrhythmia were compared before and after treatment.Results After 3and 6months of administration,the total effective rate was significantly higher in the combination group than the dronedarone group and the metoprolol group(P<0.05).The frequency of atrial fibrillation(AF)attacks[(2.31±1.78)/48hvs(11.56±18.68)/48h],AF duration[(4.86±6.73)h/48hvs(10.92±9.61)h/48h],atrial flutter(AFL)attacks[(2.33±1.53)/48hvs(4.33±1.53)/48h]and AFL duration[(5.15±4.87)h/48hvs(21.54±20.08)h/48h]in the combined group,and AFL duration[(2.75±1.94)h/48hvs(10.29±8.04)h/48h]in the dronedarone group were reduced after 6months of treatment(P<0.05).Conclusion In the treatment of atrial tachycardia,dronedarone combined with low dose metoprolol can not only obviously improve symptoms,but also significantly reduce the atrial premature and atrial tachycardia attacks,decrease the number and duration of AF and AFL attacks,and control heart rate effectively.