胺碘酮联合美托洛尔治疗冠状动脉粥样硬化性心脏病并发快速心律失常疗效观察

目的观察胺碘酮联合美托洛尔治疗冠状动脉粥样硬化性心脏病(CAHD)并发快速心律失常的临床疗效。方法 78例CAHD并发快速心律失常患者分为2组,观察组39例患者给予盐酸胺碘酮片联合酒石酸美托洛尔片治疗,对照组39例患者仅给予盐酸胺碘酮片治疗,观察2组患者治疗前后临床症状、血压和心电图的变化。结果 2组患者治疗前的心率(HR)、房性期前收缩(PAC)次数、室性期前收缩(PVC)次数、血压、心绞痛(AP)发作次数比较差异均无统计学意义(P>0.05);2组患者治疗后的HR、PAC次数、PVC次数和AP发作次数显著低于治疗前,差异均有统计学意义(P<0.05),2组患者治疗后血压与治疗前比较差异无统计学意义(P>0.05);治疗后观察组患者的HR、PAC次数、PVC次数和AP发作次数显著低于对照组,差异均有统计学意义(P<0.05),治疗后2组患者血压比较差异无统计学意义(P>0.05)。观察组和对照组患者临床症状改善总有效率分别为94.87%和71.79%,观察组患者的临床症状改善总有效率显著高于对照组(P<0.05)。观察组和对照组患者的24 h动态心电图改善总有效率分别为92.31%和66.67%,观察组患者24 h动态心电图改善总有效率显著高于对照组(P<0.05)。结论美托洛尔可以抑制交感神经兴奋,从而显著增强胺碘酮治疗CAHD并发快速心律失常的疗效,效果优于单独应用胺碘酮。

Effect of amiodarone combined with metoprolol in treatment of patients with coronary atherosclerot- ic heart disease and tachyarrhythmia

Objective To observe the curative effect of amiodarone combined with metoprolol in treatment of patients with coronary atherosclerotic heart disease （CAHD） and taehyan＇hythmia. Methods A total of 78 patients with C AHD and tachyarrhythmia were divided into two groups ,39 patients in observation group were treated with amiodarone hydrochloride and metoprolol tartrate, and 39 patients in control group were treated with amiodarone hydroehloride. The clinical symptom, blood pressure and electrocardiogram of patients were observed before and after treatment. Results There was no significant differ- ence in heart rate（HR） ,the number of premature atrial contraction（PAC） and premature ventricualr contraction（PVC） ,blood pressure,angina pectoris（AP） episodes between the two groups beiore treatment （P 〉 0.05 ）. The HR, the number of PAC, PVC and AP after treatment were significantly lower than those before treatment in the two groups（ P 〈 0.05 ）. There was no significant difference in blood pressure pre-and post-treatment in the two groups （ P 〉 0.05 ）. The HR, the number of PAC, PVC and AP in observation group were significantly lower than those in control group after treatment（ P 〈 0.05 ）. There was no sig- nificant difference in blood pressure between the two groups ＇after treatment （ P 〉 0.05 ）. The total effective rate of elinical symptom improvement in observation group and control group was 94.87% and 71.79% respectively,the total effective rate of clinical symptom improvement in observation group was significantly higher than that in control group （P 〈 0.05 ）. The total ef- fective rate of 24 horn＇s dynamic electrocardiogram improvement in observation group and control group was 92.31% and 66. 67 % respectively, The total effective rate of 24 hours dynamic electrocardiogram improvement in observation group was sig- nificantly higher than that in control group（ P 〈 0.05 ）. Conclusion Metoprolol can inhibit sympathetic excitement, thus sig- nificantly enhance the curative effect of amiodarone in treatment of patients with CAHD and tachyarrhythmia, the curative effect is better than that of amiodarone monotherapy.