不同剂量美托洛尔联合胺碘酮治疗快速心律失常的疗效

目的：探讨不同剂量美托洛尔联合胺碘酮治疗快速心律失常的疗效。方法：选择120例快速心律失常患者，应用数字表法使患者被随机分为：小剂量组（美托洛尔5mg/d），中剂量组（美托洛尔10mg/d），大剂量组（美托洛尔15mg/d）。每组各40例，均联合胺碘酮治疗。比较三组的起效时间，窦性心律转复率，平均血压，心率值，左室射血分数（LVEF），有效率以及不良反应发生率。随访3月，比较三组快速心律失常再发率差异。结果：与小剂量组比较，中剂量组与大剂量组的起效时间（7.2±1.1）h比（3.4±1.0）h、（2.9±0.8）h]显著缩短，窦性心律转复率（57.5％比85.0％、90.0％）及有效率（62.5％比90.0％、95.0％）显著提高（P＜0.05或0.01），而大剂量组与中剂量组无差异（P均＞0.05），但三组的平均血压、心率值及 LVEF无显著差异（P＞0.05）。三组的各种不良反应发生率均无显著差异（P＞0.05）。随访3月，中剂量组再发率显著小于大剂量组与小剂量组（2.5％比10.0％、20.0％，P＜0.05）。结论：中等剂量的美托洛尔联合胺碘酮对于快速心律失常患者的疗效优于小、大剂量两组，值得推荐。

Therapeutic effect of different dosages of metoprolol combined amiodarone on tachyarrhythmia

Objective：To compare clinical therapeutic effects of different dosages of metoprolol combined amiodarone on patients with tachyarrhythmia.Methods：A total of 120 patients with tachyarrhythmia were randomly divided into small-dose group （n=40,received 5mg/d metoprolol）,medium-dose group （n=40,received 10mg/d metoprolol）and large-dose group （n=40,received 15mg/d metoprolol）according to number table method.Each group received combined amiodarone therapy.Clinical indexes such as acting time,sinus rhythm conversion rate and left ventricular ejection fraction （LVEF）were compared among three groups.After three-month follow up,recurrence rate of tachyarrhythmia was compared among three groups.Results：Compared with small-dose group,there was significant reduction in acting time （7.2±1.1）h vs.（3.4±1.0）h,（2.9±0.8）h],and significant rise in sinus rhythm conversion rate （57.5% vs.85.0%,90.0%）and effective rate （62.5% vs.90.0%,95.0%）in medium-dose group and large-dose group,P〈0.05 or 0.01,but there were no significant difference between medium-dose group and large-dose group （P〉0.05 all）.There were no significant differences in mean blood pressure and heart rate,LVEF and incidence rates of all kinds of adverse reactions among three groups （P〉0.05）.After three-month follow-up,recurrence rate of medium-dose group （2.5%）was significantly lower than those of large-dose group （10.0%）and small-dose group （20.0%）,P〈0.05. Conclusion：Medium dosage of metoprolol combined with amiodarone possesses more clinical therapeutic effect than small-dose and large-dose in patients with tachyarrhythmia;it is worth extending in clinic.