胺碘酮联合美托洛尔治疗快速心律失常的效果及对患者心率变异性的影响

Curative effect of amiodarone combined with metoprolol on tachyarrhythmias and its influence on heart rate variability

目的探讨胺碘酮联合美托洛尔治疗快速心律失常的效果及对患者心率变异性的影响。方法队列研究。抽取2021年8月至2023年8月驻马店第一人民医院心内科收治的快速心律失常患者78例为研究对象,按照随机数字表法分为对照组与研究组,每组39例。对照组予以胺碘酮治疗,观察组在胺碘酮基础上加用美托洛尔治疗。比较分析两组患者的临床疗效、心功能、心率变异性、不良反应。结果观察组临床总有效率(37/39,94.87%)高于对照组(30/39,76.92%),差异有统计学意义(P<0.05)。观察组的心输出量、心搏量、左心室射血分数均高于对照组,差异有统计学意义(P<0.05);观察组的R-R间期平均值标准差(SDANN)、全部窦性心搏RR间期的标准差(SDNN)、相邻NN之差>50 ms的个数占总窦性心搏个数的百分比(PNN50)、全程记录中每5分钟R-R间期标准差的平均值(SDNNI)、全部窦性R-R间期差值的均方根(RMSSD)均高于对照组,差异均有统计学意义(P均<0.05)。两组不良反应发生率比较差异未见统计学意义(P>0.05)。结论快速心律失常患者应用胺碘酮联合美托洛尔治疗疗效确切,能够有效控制心率变异性,改善患者心功能指标,且不增加不良反应。

Objective To investigate the clinical efficacy of amiodarone combined with metoprolol in the treatment of tachyarrhythmias and the influence on heart rate variability in patients.Methods This study was a cohort study.A total of 78 patients with tachyarrhythmias admitted to the Department of Cardiology of Zhumadian First People’s Hospital from August 2021 to August 2023 were selected as the study subjects.And the 78 patients were divided into the control group and the observation group using a random number table method,with 39 cases in each group.The control group was treated with amiodarone,while the observation group was treated with metoprolol combined with amiodarone.The clinical efficacy,cardiac function,heart rate variability,and adverse reactions were compared between the two groups.Results The total clinical effective rate of the observation group(37/39,94.87%)was higher than that of the control group(30/39,76.92%),and the difference was statistically significant(P<0.05).The cardiac output,stroke volume,and left ventricular ejection fraction of the observation group were all higher than those of the control group,and the differences were statistically significant(P<0.05).The standard deviation of the average normal-to-normal intervals,the standard deviations of normal-to-normal intervals,the percentage of intervals>50 ms different from preceding interval,standard deviation of the averages of normal-to-normal intervals in all 5-minute segments of the entire recording,and root mean square of successive differences in adjacent normal-to-normal intervals in the observation group were all higher than those in the control group,and the differences were statistically significant(all P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions Amiodarone combined with metoprolol has a definite effect in the treatment of tachyarrhythmia,which can effectively control heart rate variability,improve cardiac function indicators,without increasing adverse reactions.