比索洛尔与地高辛联合治疗对慢性心力衰竭伴阵发性房颤患者心室率及心功能的影响研究

Effects of Bisoprolol Combined with Digoxin on Ventricular Rate and Cardiac Function in Patients with Chronic Heart Failure and Paroxysmal Atrial Fibrillation

目的:探究比索洛尔与地高辛联合治疗对慢性心力衰竭伴阵发性房颤患者心室率及心功能的影响。方法:选取2021年5月—2022年5月河南省平舆县中心医院收治的114例慢性心力衰竭伴阵发性房颤患者作为研究对象,按照随机数表法分为对照组和观察组,每组各57例。两组患者均予以胺碘酮治疗,对照组患者接受地高辛治疗,观察组患者在对照组的基础上加用比索洛尔治疗。对比两组患者临床疗效、心室率、心功能、心肌能量代谢水平、生活质量及不良反应发生情况。结果:观察组患者临床总有效率高于对照组患者,差异有统计学意义(χ^(2)=5.211,P<0.05)。治疗后,观察组患者最大心室率、最小心室率、平均心室率均低于对照组患者,差异均有统计学意义(t=10.593、7.571、6.809,P<0.001)。治疗后,观察组患者左室舒张末期内径(LVEDD)、收缩末期内径(LVESD)水平均低于对照组患者,观察组患者射血分数(LVEF)水平高于对照组患者,差异均有统计学意义(t=3.569、3.621、3.624,P<0.001)。治疗后,观察组患者N末端B型脑肽前体(NT-proBNP)、肌酸激酶(CK)、心肌能量消耗(MEE)水平均低于对照组患者,差异均有统计学意义(t=18.121、9.324、5.051,P<0.001)。治疗后,观察组患者心理功能、物质生活、躯体功能、社会功能评分均高于对照组患者,差异均有统计学意义(t=8.514、9.883、15.576、8.728,P<0.001)。两组患者不良反应发生情况比较,差异无统计学意义(χ^(2)=0.134,P>0.05)。结论:对于慢性心力衰竭伴阵发性房颤患者来说,相较于单纯的地高辛治疗,加用比索洛尔治疗能够明显调节患者的心肌能量代谢水平,改善其心室率与心功能,提高其生活质量,降低其不良反应发生率。

Objective:To investigate the effect of bisoprolol combined with digoxin on ventricular rate and cardiac function in patients with chronic heart failure and paroxysmal atrial fibrillation.Methods:114 patients with chronic heart failure and paroxysmal atrial fibrillation admitted to the hospital from May 2021 to May 2022 were selected and randomly divided into two groups,with 57 patients in each group.Both groups of patients were treated with amiodarone,while the control group received digoxin treatment.The clinical efficacy,ventricular rate,cardiac function,myocardial energy metabolism level,quality of life,and adverse reactions between the two groups were compared.Results:The total clinical effective rate of observation group was higher than the control group,with statistically significant difference(χ^(2)=5.211,P<0.05).After treatment,the maximum ventricular rate,minimum ventricular rate and average ventricular rate in the observation group were lower than those in the control group(t=10.593,7.571,6.809;P<0.001).LVEDD and LVESD were lower than those in the control group,LVEF was higher than those in the control group(t=3.569,3.621,3.624;P<0.001).NT proBNP,CK and MEE were all lower than those in the control group(t=18.121,9.324,5.051;P<0.001).The scores of social function,psychological function,physical function and material life were higher than those of the control group,with statistically significant differences(t=8.514,9.883,15.576,8.728;P<0.001).There was no statistically significant difference in adverse reactions between the two groups(χ^(2)=0.134,P>0.05).Conclusion:For patients with chronic heart failure and paroxysmal atrial fibrillation,compared to simple digoxin treatment,the addition of bisoprolol can significantly regulate myocardial energy metabolism levels,improve ventricular rate and heart function,improve quality of life,and reduce fewer adverse reactions.