胺碘酮联合美托洛尔治疗冠心病合并心律失常临床研究

Clinical Research of Amiodarone and Metoprolol on paients withcoronary heart disease by cardiac arrhythmias

目的：观察胺碘酮联合美托洛尔治疗冠心病合并心律失常的临床效果。方法：将2015年6月～2016年4月在我院就诊的冠心病合并心律失常患者121例，随机分为对照组60例和治疗组61例，对照组患者口服胺碘酮片200mg/次，3次/d；联合治疗组给予胺碘酮片和美托洛尔片，起始剂量为口服12.5mg/次，2次/d，随后对两组临床资料进行回顾性分析。结果：治疗组总有效率为90.1%，高于对照组的70.0%，差异有统计学意义；治疗后两组患者心率[（71.7±8.7）、（63.6±7.3）次/min]和QTd[（49.7±15.3）、（42.5±15.6）ms]均明显减少，与治疗前相比差异有统计学意义，且治疗组水平低于对照组，差异有统计学意义；治疗组患者的室性早搏次数[（1832.3±532.6）次]、房性早搏[（359.3±177.6）次]和交界性早搏次数[（433.1±163.2）次]与对照组比较，差异均有统计学意义。结论：美托洛尔联合胺碘酮治疗冠心病并发心律失常效果优于单药治疗，建议临床推广。

Objective To investigate combined therapeutic efficiency of Metoprolol and Amiodarone on patients with coro-nary heart disease by cardiac arrhythmias. Methods 121 patients with cardiac arrhythmias from June 2015 to April 2016 were randomly divided into 60 cases of control group and 61 cases of treatment group. The control group was given Amiodarone 200 mg per time,3 times a day,and the treatment group was given Amiodarone and Metoprolol,initial dose was 12.5 mg per time, 2 times a day Results The total effective rate of treatment group was 90.1%,higher than the control group(74.0%)significantly;heart rate[(71.7±8.7),(633.6±7.3)times/min]and QTd[(49.7±15.3),(42.5±15.6)ms]of control group and treatment group significantly decreased after treatment,compared with before treatment,and the difference was statistically significant, ventricular premature beat[(1832.3±532.6)times],atrial premature beat[(359.3±177.6)times]and junctional premature beat[(433.1±163.2)times]of treatment group were less than control group significantly . Conclusion Combined therapeutic efficiency of Amiodarone and Metoprolol have good curative effect on elderly patients with coronary heart disease by cardiac ar-rhythmias,adverse reactions are lower,and it is worthy of being applied in clinic.