Efficacy of Metoprolol Succinate Sustained Release Tablets Combined with Wenxin Granules in the Treatment of Coronary Heart Disease Arrhythmia

Objective:To explore the effect of metoprolol succinate sustained-release tablets combined with Wenxin Granules in the treatment of coronary heart disease patients with arrhythmia.Methods:The research objects were 50 patients with arrhythmia who were treated in our hospital from September 2019 to September 2020.According to different treatment methods,they were divided into observation group(Wenxin Granule+metoprolol succinate treatment)and control group(metoprolol succinate treatment),25 cases in each group.The curative effects of the two groups were compared.Results:After treatment,there was no significant difference in rnn50,RMSSD,sdnni and SDANN between the two groups(P>0.05).Compared with the control group,the SDNN in the observation group was higher than that in the control group(P<0.05);Before treatment,there was no significant difference in the above indexes between the two groups(P>0.05);The effective rates of the observation group and the control group were 92.00%and 68.00%respectively,and the curative effect of the observation group was higher than that of the control group(P<0.05);There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:In the treatment of patients with coronary heart disease and arrhythmia,Wenxin Granule Combined with metoprolol succinate sustained-release tablets has significant effect,which can effectively improve the dynamic electrocardiogram indexes of patients,improve the clinical efficacy,and has high safety.

Combined Effect of Smoking and Obesity on Coronary Heart Disease Mortality in Male Veterans:A 30-year Cohort Study

Objective Evidence is lacking regarding the combined effects of smoking and obesity on mortality from coronary heart disease in male veterans.This study aimed to explore the combined effect of smoking and obesity on coronary heart disease mortality in male veterans in China.Methods A cohort of 1,268 male veterans from 22 veteran centers in Xi’an(Shaanxi Province,China)were followed up once every 2 years from February 1,1987 to October 30,2016.The endpoint was death from any cause.The hazard ratio(HR)of each risk factor and the 95%confidence interval(CI)were calculated using a multivariate Cox proportional hazard model.Results The total follow-up was 24394.21 person-years;each subject was followed up for a mean duration of 19.24 years.By the end of the study,of the 1,268 veterans,889 had died,363 were alive,and 16 were lost to follow-up.Cox regression analysis results revealed that current smoking(HR:1.552,95%CI:1.074–2.243),obesity(HR:1.625,95%CI:1.024–2.581),and the combined effect of the two factors(HR:2.828,95%CI:1.520–5.262)were associated with coronary heart disease mortality.Conclusion Our results suggest that obese veterans who smoke might be an important target population for coronary heart disease mortality control.

Clinical characteristics of Danshen Ligustrazine injection in the treatment of coronary heart disease with hypertension-A real world study

Objective:To explore the characteristics and rules of Danshen Ligustrazine Injection in the treatment of coronary heart disease with hypertension.Methods:From the information systems of 12 tertiary tier-one hospitals across the country,we extracted the medical data of the application of Danshen Ligustrazine Injection in the treatment of patients with coronary heart disease and hypertension.After normalization,the model was established by Apriori algorithm,and the association rules were analyzed by Clementine 12.0 software.Results:Most of the 1928 patients were between 75 and 90 years old(54.26%).There were more males than females,most with type 2 diabetes,cerebral infarction,etc.Each dose was more than 10 mL(52.78%).Aspirin enteric-coated tablets(67.63%),L-carnitine injection(58.77%),and atorvastatin calcium capsules(50.93%)were often used in combination with safflower yellow pigment(22.20%),Shexiang Baoxin Pill(16.55%),Suxiao Jiuxin Pill(15.09%);the most commonly used combination of western medicine was anticoagulant thrombolytic and antiplatelet drugs(85.84%),and the type of Chinese medicine was Huoxuehuayu(72.98%);The most common combination of two western medicines was L-carnitine injection+aspirin enteric-coated tablets,with a support of 41.9%;The most common combination of two Chinese and western medicines is western medicine·anti-anginal medicine+western medicine·anticoagulant thrombolytic and antiplatelet drugs with a support of 67.6%.Conclusion:Danshen Ligustrazine injection is mainly used in elderly patients with coronary heart disease and hypertension,with many comorbidities.The dosage standard needs to be optimized.The combination of drugs and guidelines should coordinate with each other,which provide clues for clinical diagnosis and treatment and optimization of medication.

Effects of lornoxicam combining with fentanyl on postoperative arrhythmia and platelet function in patients with coronary artery disease after abdominal surgery

To investigate the effects of patient-controlled intravenous analgesia (PCIA) with lornoxicam and fentanyl on arrhythmia and the expression of platelet membrane glycoproteins in patients with coronary artery disease (CAD) after abdominal surgery.Methods Eighty ASA Ⅱ or Ⅲ patients with CAD aged 51～66 yrs weighing 59～68 kg presenting for abdominal surgery participated in this study.CAD was diagnosed by clinical symptoms and ischemic changes on ECG.The patients were premedicated with intramuscular henobarbital 0.1 g and scopolamine 0.3 mg.Anesthesia was induced with fentanyl,droperidol,propofol and vecuronium and maintained with propofol,fentanyl and vecuronium.The patients received PCIA after operation.The PCIA solution contained fentanyl 0.9 mg and droperidol 5 mg in 100 ml of normal saline (N.S.) in group A (n=40) or lornoxicam 56 mg,fentanyl 0.2 mg and droperidol 5 mg in 100 ml N.S. in group B (n=40).In group A the loading dose was fentanyl 0.05 mg and group B lornoxicam 4 mg.PCIA included a background infusion at 2 ml·h -1 and a bolus of 0.5 ml with a 15 min lock-out.VAS(0=no pain,10= worst pain) was used to measure pain intensity.In addition to BP,HR and SpO2 monitoring ECG was continuously monitored with a Holter monitor after operation.Blood samples were taken from peripheral vein before and 6 h after operation and on the 1st,2nd,7th and 8th postoperative days for determination of the expression of CD 62p ,CD 63 and CD 41 /CD 61 on the platelet membrane,platelet count,prothrombin time (PT) thrombin time (TT) and partial thromboplastin time (PTT).Results The two groups were comparable with respect to sex,age,body weight,severity of CAD,duration of operation and intraoperative blood loss.The patients received no blood transfusion during operation.There was no significant difference in VAS score,platelet count,PT,TT and PTT between the two groups.The incidence of atrial and ventricular premature beat on ECG and the expression of CD 41 /CD 61 ,CD 62p and CD 63 on the platelet membrane were significantly lower in group B than in group A on the 7th and 8th postoperative days(P<0.05 or 0.01).Conclusion Postoperative PCIA with lornoxicam and fentanyl can more effectively reduce the incidence of postoperative arrhythmia in patients with CAD.Suppression of activation of platelets by lornoxicam may contribute to the mechanism.10 refs,3 tabs.

Vagal nerve stimulation in prevention and management of coronary heart disease

Coronary heart disease (CHD) that is due to atherosclerosis is associated with low-grade systemic inflammation. Congestive cardiac failure and arrhythmias that are responsible for mortality in CHD can be suppressed by appropriate vagal stimulation that is anti-inflammatory in nature. Acetylcholine, the principal vagal neurotransmitter, is a potent anti-inflammatory molecule. Polyunsaturated fatty acids (PUFAs) augment acetylcholine release, while acetylcholine can enhance the formation of prostacyclin, lipoxins, resolvins, protectins and maresins from PUFAs, which are anti-inflammatory and anti-arrhythmic molecules. Furthermore, plasma and tissue levels of PUFAs are low in those with CHD and atherosclerosis. Hence, vagal nerve stimulation is beneficial in the prevention of CHD and cardiac arrhythmias. Thus, measurement of catecholamines, acetylcholine, various PUFAs, and their products lipoxins, resolvins, protectins and maresins in the plasma and peripheral leukocytes, and vagal tone by heart rate variation could be useful in the prediction, prevention and management of CHD and cardiac arrhythmias.

Risk of cardiovascular,cardiac and arrhythmic complications in patients with non-alcoholic fatty liver disease

Non-alcoholic fatty liver disease(NAFLD)has emerged as a public health problem of epidemic proportions worldwide.Accumulating clinical and epidemiological evidence indicates that NAFLD is not only associated with liver-related morbidity and mortality but also with an increased risk of coronary heart disease(CHD),abnormalities of cardiac function and structure(e.g.,left ventricular dysfunction and hypertrophy,and heart failure),valvular heart disease(e.g.,aortic valve sclerosis)and arrhythmias(e.g.,atrial fibrillation).Experimental evidence suggests that NAFLD itself,especially in its more severe forms,exacerbates systemic/hepatic insulin resistance,causes atherogenic dyslipidemia,and releases a variety of pro-inflammatory,pro-coagulant and pro-fibrogenic mediators that may play important roles in the pathophysiology of cardiac and arrhythmic complications.Collectively,these findings suggest that patients with NAFLD may benefit from more intensive surveillance and early treatment interventions to decrease the risk for CHD and other cardiac/arrhythmic complications.The purpose of this clinical review is to summarize the rapidly expanding body of evidence that supports a strong association between NAFLD and cardiovascular,cardiac and arrhythmic complications,to briefly examine the putative biological mechanisms underlying this association,and to discuss some of the current treatment options that may influence both NAFLD and its related cardiac and arrhythmic complications.

心肺联合康复对冠心病介入治疗后患者血脂、心肺功能的影响

目的探讨心肺联合康复对冠心病介入治疗后患者血脂、心肺功能的影响。方法选择2022-11至2023-11秦皇岛市第一医院收治的接受介入治疗后的冠心病患者180例为研究对象,随机分为对照组(n=89)和试验组(n=91),对照组进行常规药物治疗,试验组进行心肺联合康复治疗,干预时间均为3个月。对两组患者干预前后的血脂水平、心肺功能、运动功能、生活质量和自我管理能力进行比较。结果与干预前对比,两组干预后,三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、用力呼气量与用力肺活量比值(FEV/FVC%)、1 s用力呼气量(FEV_(1))、左心室射血分数(LVEF)、生理功能、躯体疼痛等均有明显改善,差异有统计学意义(P<0.05),试验组比对照组各项指标(LDL-C、FEV/FVC%、PEAKVO2等)改善更明显,差异有统计学意义(P<0.05)。结论心肺联合康复可降低冠脉介入术后患者的血脂水平,增强心肺功能及运动功能,提高生活质量。

益气养心方治疗冠心病室性心律失常的疗效及其对心肌缺血的血液流变学指标、CXCL9水平的影响

目的观察益气养心方治疗冠心病室性心律失常的临床疗效及其对心肌缺血的血液流变学指标、CXC趋化因子配体9(CXCL9)水平的影响。方法选取2021年6月至2022年12月在该院治疗的70例冠心病室性心律失常患者作为研究对象,采用随机数字表法分为对照组和观察组,每组35例。两组患者均实施常规对症治疗,对照组在常规对症治疗的基础上给予酒石酸美托洛尔片治疗,观察组在对照组的基础上给予益气养心方治疗,两组患者均连续治疗4个月。观察两组临床疗效、血液流变学指标水平、血清CXCL9水平及不良反应情况。结果观察组治疗后总有效率高于对照组(P<0.05);两组治疗后全血低切黏度、全血高切黏度、血浆比黏度、纤维蛋白水平均低于治疗前,且观察组均低于对照组(P<0.05);两组治疗后血清CXCL9水平均低于治疗前,且观察组低于对照组(P<0.05);两组治疗过程中均未见严重不良反应,仅有极少数患者出现轻微恶心、呕吐症状。结论益气养心方治疗冠心病室性心律失常临床疗效较佳,可调低血清CXCL9水平,减轻心肌损伤,改善心肌的血液流变学指标,促进心律失常改善,且治疗安全性较高。

动态心电图与常规心电图诊断冠心病伴心律失常的效果比较

目的:比较动态心电图与常规心电图诊断冠心病伴心律失常的效果。方法:选取2018年1月—2022年1月赤峰市医院心内科收治的120例冠心病伴心律失常患者作为研究对象,均进行常规心电图检测与动态心电图检测,比较两种检测方法诊断冠心病伴心律失常的效果。结果:动态心电图对冠心病的检出率高于常规心电图,差异有统计学意义(P<0.001)。冠状动脉造影、动态心电图对单支与多支冠状动脉病变的检出率均高于常规心电图,差异有统计学意义(P<0.05);动态心电图与冠状动脉造影对单支与多支冠状动脉病变的检出率比较,差异无统计学意义(P>0.05)。常规心电图与动态心电图对房性早搏早发、室性早搏早发的检出率比较,差异无统计学意义(P>0.05);动态心电图对室性早搏二三联律、房性早搏二三联律、室性早搏成对、房性早搏成对、短阵室上速的检出率高于常规心电图,差异有统计学意义(P<0.001)。结论:动态心电图诊断冠心病伴心律失常的效果显著,冠心病阳性检出率、冠状动脉病变检出率、心律失常检出率均优于常规心电图。

炙甘草汤联合西药治疗气阴两虚型冠心病合并室性心律失常患者的效果

目的探讨炙甘草汤联合西药治疗气阴两虚型冠心病合并室性心律失常(VA)的临床效果。方法选取济南市第三人民医院2022年1月—2023年10月收治的56例冠心病合并VA患者为研究对象,按随机数字表法将其分为对照组和观察组,每组28例。对照组采用西药治疗,观察组在此基础上采用炙甘草汤治疗,均持续6周。比较两组患者的临床疗效、心电图指标、中医证候积分及不良反应发生情况。结果观察组的治疗总有效率为92.86%,高于对照组的71.43%,差异有统计学意义(P<0.05)。治疗6周后,观察组的室性期前收缩数、短阵室速数分别为(2824.63±225.31)次/24 h、(1.82±0.23)次/24 h,均少于对照组的(3025.59±234.16)次/24 h、(2.89±0.35)次/24 h,QT间期为(458.63±45.32)ms,长于对照组的(419.63±44.25)ms,QT离散度为(37.12±3.25)ms,短于对照组的(42.65±4.18)ms,组间差异有统计学意义(P<0.05);观察组的心悸胸闷、气短乏力、头晕眼花、失眠健忘积分分别为(0.76±0.13)分、(0.65±0.11)分、(0.59±0.11)分、(0.62±0.13)分,均低于对照组的(0.89±0.15)分、(0.84±0.13)分、(0.78±0.13)分、(0.81±0.14)分,组间差异有统计学意义(P<0.05)。两组的不良反应发生率比较,差异无统计学意义(P>0.05)。结论炙甘草汤联合西药可提高冠心病合并VA患者的治疗效果,改善其心电图指标,降低中医证候积分,且安全性良好。

细辛在心血管疾病治疗中的应用

细辛最早载于《神农本草经》,历代本草亦有记载发挥,临床应用广泛,其中对心系疾病治疗的记载始于《肘后备急方》。该文系统梳理细辛在冠心病、缓慢性心律失常、肺心病中的应用,提出细辛可开通心之玄府与血脉、温肾助阳,适合寒邪痹阻型冠心病患者,多与荜茇、良姜、附子等配伍;细辛可鼓动心阳直接提高心率,或与麻黄、桂枝等合用治疗阳郁寒凝型缓慢性心律失常患者;细辛可散寒止咳、畅通肺气治疗寒邪蕴肺、肺失宣降所致肺心病患者,多与干姜、五味子、茯苓等伍用。药理研究显示,细辛可调节心脏泵血系统,加快心脏传导,调节血管舒缩,为其治疗心血管疾病提供了依据。最后,该文梳理细辛临床用量与毒理学研究,认为在辨证准确、没有禁忌证且非单味应用的情况下,细辛全草入煎剂治疗心血管疾病可不拘泥于3 g以内的限制,但应中病即止。

美托洛尔联合瑞舒伐他汀治疗老年冠心病并室性心律失常临床研究

目的探讨美托洛尔联合瑞舒伐他汀治疗老年冠状动脉粥样硬化性心脏病(简称冠心病)并室性心律失常的临床疗效。方法选取医院2020年1月至2023年2月收治的冠心病并室性心律失常老年患者98例,按随机数字表法分为观察组和对照组,各49例。两组患者均予利尿剂、血管扩张剂、抗血小板聚集药物等基础治疗,并口服瑞舒伐他汀钙片,观察组患者加服琥珀酸美托洛尔缓释片。两组患者均连续治疗3个月。结果观察组总有效率为95.92%,显著高于对照组的81.63%(P<0.05)。与治疗前比较,两组患者治疗后的室性期前收缩、成对室性期前收缩、短期阵发室性心动过速发作次数24 h内均显著减少,左心室射血分数显著升高,左心室舒张末期内径、左心室收缩末期内径均显著缩短(P<0.05);血管内皮生长因子、一氧化氮水平均显著升高,内皮素-1、可溶性生长刺激表达基因2蛋白、心肌肌钙蛋白I、N末端脑钠肽前体水平均显著降低(P<0.05);肿瘤坏死因子-α、髓过氧化物酶、超敏C反应蛋白、低密度脂蛋白胆固醇、甘油三酯、总胆固醇水平均显著降低,高密度脂蛋白胆固醇水平均显著升高(P<0.05);三水平五维健康量表中视觉模拟量表评分显著升高(P<0.05)。观察组以上指标改善幅度均显著大于对照组(P<0.05)。观察组与对照组不良反应发生率相当(12.24%比10.20%,P>0.05)。结论美托洛尔联合瑞舒伐他汀治疗老年冠心病并室性心律失常,能减少室性心律失常的发作次数,改善心功能、血管内皮功能及血脂水平,抑制心肌损伤及炎性反应,提高患者的生活质量。

基于病证结合的冠心病动物模型制备研究进展与思考

冠心病的临床研究和动物实验研究一直是心血管领域的常见病。病证结合动物模型体现了中西医结合的理念,不仅有西医的疾病特点,而且借助中医思维用不同实验方法来表现独特的中医证候特点,是中医药研究冠心病预防和治疗的有效工具。文章对常用冠心病中医证候的动物模型建立方法进行总结,并以冠心病痰瘀互结证动物模型为例提出思考。

代谢综合征合并冠心病案——仝小林院士教学查房实录

以广安门医院内分泌科1例代谢综合征合并冠心病患者为例邀请仝小林院士进行教学查房,对代谢综合征合并冠心病的中医辨治思路、疾病发展、诊疗要点进行阐述。强调辨别脾瘅与消瘅异同,把握疾病发展的不同趋势,脾瘅易合并大血管、微血管并发症,消瘅则微血管并发症多见。注重脉络并治,从肝论治,注重运用态靶辨治体系,减少西药的使用。

参松养心胶囊联合瑞舒伐他汀钙片对老年冠心病合并心律失常患者心律失常发作次数及血管弹性的影响

目的:探讨参松养心胶囊联合瑞舒伐他汀钙片对老年冠心病合并心律失常患者心律失常发作次数及血管弹性的影响。方法:选取2021年2月~2023年1月期间某院心内科收治的110例老年冠心病合并心律失常患者作为研究对象,采用随机数字表法分为对照组和观察组,每组55例。两组患者均给予常规西医治疗,对照组患者在常规治疗基础上口服瑞舒伐他汀钙片,观察组在对照组治疗基础上口服参松养心胶囊,两组均治疗4周。比较两组患者临床疗效、心律失常(室性期前收缩、房性期前收缩、交界性期前收缩、短阵心房颤动)发作次数、血管弹性指标[臂踝脉搏波传导速度(baPWV)及颈股动脉脉搏波传导速度(cfPWV)、踝肱指数(ABI)]、中医证候积分、左室射血分数(LVEF)、脑钠肽(BNP)、心肌肌钙蛋白I(cTnI)、CXC趋化因子配体16(CXCL16)、超敏C反应蛋白(hs-CRP)水平及不良反应发生情况。结果:治疗后,观察组患者治疗总有效率(94.55%)高于对照组(81.82%,P<0.05);两组患者室性期前收缩、房性期前收缩、交界性期前收缩、短阵心房颤动发作次数均减少(P<0.05),且观察组低于对照组(P<0.05);两组患者cfPWV、baPWV均降低(P<0.05),且观察组低于对照组(P<0.05);两组患者ABI均升高(P<0.05),且观察组高于对照组(P<0.05);两组患者中医证候积分均降低(P<0.05),且观察组低于对照组(P<0.05);两组患者LVEF均升高(P<0.05),且观察组高于对照组(P<0.05);两组患者BNP、cTnI、CXCL16、hs-CRP水平均降低(P<0.05),且观察组低于对照组(P<0.05)。治疗期间两组患者均未出现严重不良反应。结论:参松养心胶囊联合瑞舒伐他汀钙片治疗老年冠心病合并心律失常患者临床疗效确切,可有效改善患者血管弹性,减少心律失常发作次数,降低BNP、cTnI、CXCL16、hs-CRP水平。

颜乾麟从心肝论治心血管疾病经验

介绍颜乾麟教授从心肝论治心血管疾病的临床经验。认为心肝二脏生理相互联系、病理相互影响,心血管疾病发生发展与心肝功能失调相关,故治疗上强调心肝同治,以调肝为主,并提出舒畅气机、升降气机、降气平逆和理气活血为基本治法。并附验案1则。

基于期刊文献数据库的冠心病心律失常中医用药规律研究

目的 运用数据挖掘方法分析中医治疗冠心病心律失常的临床用药规律。方法 收集维普网数据库、万方数据知识服务平台和中国知网(CNKI)等数据库中以冠心病心律失常为主题词收集相关的文献,检索时限自建库至2023年1月,并筛选出中药处方数据,利用Excel 2019归纳整理原始方药数据,核对各味中药的性、味、归经信息并分别进行频数统计。应用SPSS Modeler 18.3软件基于Apriori算法进行关联规则分析,应用IBM SPSS Statistics 25.0对处方数据进行聚类分析和因子分析。结果 共收录符合标准的文献99篇,从中录入中药处方99组,包含133味中药,中药累积使用频次1 091次。其中甘草、丹参、桂枝等高频中药(频次≥20)共16味,性味以温、寒、甘、苦居多,归经主要以脾经、肝经、肺经为主,二阶关联规则分析中以甘草—桂枝支持度最高;三阶关联药物中以甘草—麦冬—丹参的组合支持度最高。因子分析降维得出5个公因子,功效主要有滋阴养血、益气活血等。结论 冠心病心律失常用药性味以苦寒为主,多从脾、肝、肺三经出发,功效相对集中,以滋阴养血、益气通脉为主。

基于高效通道注意力机制和特征融合网络的冠心病诊断算法研究

针对冠心病重要特征不确定、诊断模型预测性能低等因素而导致冠心病早期诊断精度低的问题,提出一种基于高效通道注意力机制和特征融合的网络。通过XGBoost(eXtreme Gradient Boosting)来确定冠心病重要特征,设计数据生成图片的特征组合算法以适用该模型;为提高诊断模型预测性能,采用可以提升模型学习能力和特征利用率的高效通道注意力机制模块和特征融合模块。实验结果表明,在UCI克利夫兰心脏病数据集上,与其他诊断算法相比,该算法优于传统机器学习方法,预测精度可达100%且稳定性好。

参松养心胶囊联合美托洛尔缓释片治疗老年冠心病心律失常患者的临床效果

目的研究参松养心胶囊联合美托洛尔缓释片治疗老年冠心病心律失常患者的临床效果。方法回顾性选取2020年6月至2021年6月我院收治的96例老年冠心病心律失常患者作为研究对象,依据治疗方法不同将其分为联合治疗组(美托洛尔缓释片联合参松养心胶囊治疗)和单独治疗组(美托洛尔缓释片治疗),各48例。比较两组的治疗效果。结果联合治疗组的治疗总有效率高于单独治疗组(P<0.05)。治疗后,联合治疗组的心功能分级优于单独治疗组(P<0.05)。治疗后,联合治疗组的心排出量、心脏指数、射血分数均高于单独治疗组(P<0.05)。联合治疗组的室性期前收缩、房性期前收缩、交界性期前收缩、短阵心房颤动发生次数均少于单独治疗组(P<0.05)。治疗后,联合治疗组的缺血发生次数、缺血总负荷低于单独治疗组,缺血持续时间短于单独治疗组(P<0.05)。联合治疗组的不良反应总发生率低于单独治疗组(P<0.05)。结论参松养心胶囊联合美托洛尔缓释片治疗老年冠心病心律失常效果显著,可减少其心律失常发作频率,改善心功能。

酒石酸美托洛尔联合盐酸胺碘酮片对冠心病伴心律失常患者心功能及用药不良反应的影响

目的探讨酒石酸美托洛尔联合盐酸胺碘酮片对冠心病(CHD)伴心律失常患者心功能及用药不良反应的影响。方法选择2021年1月至2022年6月收治的96例CHD伴心律失常患者作为研究对象,将其随机分为单一组和联合组,每组48例。单一组给予盐酸胺碘酮片治疗,联合组在单一组治疗基础上增加酒石酸美托洛尔治疗。比较两组的治疗效果。结果联合组的治疗总有效率显著高于单一组(P<0.05)。治疗后,联合组的左心室射血分数(LVEF)高于单一组,左心室收缩末期内径(LVESD)、左心室收缩末期容积(LVESV)及左心室舒张末期容积(LVEDV)小于单一组(P<0.05)。治疗后,联合组的QT离散度、QRS波时限变化、室性期前收缩频率、短阵室性心动过速频率显著低于单一组,窦性心博R-R间期标准差及相邻窦性心律R-R间期平均值高于单一组(P<0.05)。治疗后,联合组的B型脑钠肽(BNP)、心肌肌钙蛋白T(cTnT)、可溶性ST_(2)蛋白(sST_(2))及血乳酸(BLA)水平显著低于单一组(P<0.05)。两组治疗期间的不良反应总发生率比较,差异无统计学意义(P>0.05)。结论酒石酸美托洛尔联合盐酸胺碘酮片治疗CHD伴心律失常患者可取得安全高效的理想效果。