酒石酸美托洛尔片联合胺碘酮治疗冠心病伴快速性心律失常的有效性和安全性

Efficacy and safety of metoprolol tartrate tablets combined with amiodarone in the treatment of coronary heart disease with tachyarrhythmia

目的探讨酒石酸美托洛尔片联合胺碘酮治疗冠心病伴快速性心律失常的有效性和安全性。方法选取2019年1月至2022年1月韩城市人民医院收治的80例冠心病伴快速性心律失常患者为研究对象,根据随机数字排列法将其分为对照组和观察组,各40例。对照组采用胺碘酮治疗,观察组在对照组基础上联合酒石酸美托洛尔片治疗。比较两组的治疗效果。结果观察组的治疗总有效率高于对照组(P<0.05)。治疗后,观察组的左心室舒张末期内径(LVEDD)、左心室后壁舒张末期厚度(LVPWT)、左心室收缩末期内径(LVESD)及心率低于对照组,左心室射血分数(LVEF)高于对照组(P<0.05)。治疗后,观察组的全部窦性心律R-R间期标准差(SDNN)、每5 min时段窦性R-R间期平均值标准差(SDANN)、相邻R-R间期差值的均方根(RMSSD)及相邻R-R间期差值>50 ms的个数占总窦性R-R间期个数的百分比(PNN50)高于对照组(P<0.05)。观察组的胸痛、心悸、气短及乏力持续时间短于对照组(P<0.05)。两组的不良反应总发生率无明显差异(P>0.05)。结论酒石酸美托洛尔片联合胺碘酮治疗冠心病伴快速性心律失常的效果理想,可纠正患者的心率变异,改善心功能,缓解临床症状,且安全性较高。

Objective To investigate the efficacy and safety of metoprolol tartrate tablets combined with amiodarone in the treatment of coronary heart disease with tachyarrhythmia.Methods A total of 80 patients with coronary heart disease and tachyarrhythmia admitted in the People's Hospital of Hancheng from January 2019 to January 2022 were selected as the research objects.According to the random digital arrangement method,the patients were divided into control group and observation group,with 40 cases in each group.The control group was treated with amiodarone,and the observation group was treated with metoprolol tartrate tablets on the basis of the control group.The therapeutic effects of the two groups were compared.Results The total effective rate of treatment in the observation group was higher than that in the control group(P<0.05).After treatment,the left ventricular end-diastolic diameter(LVEDD),left ventricular posterior wall end-diastolic thickness(LVPWT),left ventricular end-systolic diameter(LVESD)and heart rate in the observation group were lower than those in the control group,and the ventricular ejection fraction(LVEF)was higher than that of the control group(P<0.05).After treatment,the standard deviation of normal-to-normal R-R intervals(SDNN),standard deviation of the averaged normal sinus R-R intervals for all 5-minute segments over 24 hours(SDANN),root mean square of successive differences in R-R interval(RMSSD)and percentage of the number of pairs of adjacent R-R intervals differing by more than 50 ms(PNN50)in the observation group were higher than those in the control group(P<0.05).The duration of chest pain,palpitation,shortness of breath and fatigue in the observation group were shorter than those in the control group(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion The metoprolol tartrate tablets combined with amiodarone in the treatment of coronary heart disease with tachyarrhythmia has ideal effect,it can correct the heart rate variability of patients,improve cardiac function,relieve clinical symptoms,and has high safety.