美托洛尔联合射频消融对儿童心律失常性心肌病的疗效

Therapeutic effect of metoprolol combined with radiofrequency ablation on arrhythmia-induced cardiomyopathy in children

目的探究美托洛尔联合射频消融治疗儿童心律失常性心肌病(AIC)的效果。方法选取我院2021年1月—2022年1月收治的AIC患儿并按随机数字表法分为对照组(射频消融治疗)和观察组(美托洛尔联合射频消融),各47例,比较两组患儿疗效和不良反应。结果治疗后,对照组和观察组左室舒张末径(LVEDD)值分别为2.60 mm和1.70 mm,平均心率、最快心率分别为(113.61±20.13)次·min-1和(101.22±18.72)次·min-1、(151.75±27.63)次·min-1和(135.22±25.24)次·min-1,脑钠肽(BNP)升高率和肌钙蛋白Ⅰ(cTnI)升高率分别为44.68%和12.76%、23.40%和10.63%,肌酸激酶同工酶(CK-MB)和红细胞沉降率(ESR)水平分别为(5.16±0.96)ng·mL^(-1)和(3.10±1.01)ng·mL^(-1)、(11.63±3.96)mm·h-1和(6.12±2.25)mm·h-1,均较治疗前降低(P<0.05);对照组和观察组左室射血分数(LVEF)和左室缩短分数(LVFS)值分别为(55.89±5.82)%和(64.33±6.11)%、29.42%和32.63%,较治疗前升高,且观察组指标优于对照组(P<0.05)。观察组不良反应发生率(4.25%)和对照组(6.38%)比较差异无统计学意义(P>0.05);治疗后1、2年,观察组有效率(78.71%和91.84%)高于对照组(57.44%和74.46%),再入院率(4.25%和6.38%)低于对照组(23.40%和31.91%),差异有统计学意义(P<0.05)。结论射频消融联合美托洛尔治疗儿童AIV的疗效显著,安全性高。

Objective To explore the clinical efficacy and safety of metoprolol combined with radiofrequency ablation in the treatment of arrhythmia cardiomyopathy(AIC)in children.Methods A total of 94 children with AIC admitted to our hospital from January 2021 to January 2022 were selected as subjects and randomized into the control group(radiofrequency ablation treatment,n=47)and study group(metoprolol combined with radiofrequency ablation treatment,n=47).The differences in the curative effect and incidence of adverse reactions were compared between the two groups.Results After treatment,the results in control group and study group such as the left ventricular end diastolic diameter(LVEDD)value(2.60 mm and 1.70 mm),average heart rate(113.61±20.13)beat·min^(-1) and(101.22±18.72)beat·min^(-1),fastest heart rate(151.75±27.63)beat·min^(-1) and(135.22±25.24)beat·min^(-1),brain-type natriuretic peptide(BNP)elevation rate(44.68% and 12.76%),troponin I elevation rate(23.40%and 10.63%),creatine kinase MB(CK-MB)levels(5.16±0.96)ng·mL^(-1)and(3.10±1.01)ng·mL^(-1),and erythrocyte sedimentation rate(ESR)values(11.63±3.96)mm·h^(-1) and(6.12±2.25)mm·h^(-1) were significantly lower than those before treatment(P<0.05).The left ventricular ejection fraction(LVEF)and left ventricular shortening fraction(LVFS)in the were(55.89±5.82)% and(64.33±6.11)%in the control group and 29.42% and 32.63% in the study one,which were obvious increased as compared with those before treatment(P<0.05),and all the above indicators were better in the study group than in the control after treatment(P<0.05).There was no difference in the incidence of adverse reactions between the observation group(4.25%)and the control(6.38%).One year and 2 years after treatment,the total effective rates in the study group(78.71% and 91.84%)were lower than those in the control(57.44% and 74.46%),and the readmission rates in the study group(4.25% and 6.38%)were lower than those in the control(23.40% and 31.91%),and the difference was statistically significant(P<0.05).Conclusion Radiofrequency ablation combined with metoprolol improves symptoms and has high safety in the treatment of pediatric AIC.