美托洛尔联合胺碘酮治疗冠心病慢性心力衰竭患者室性心律失常的研究

目的 探讨酒石酸美托洛尔片联合胺碘酮治疗冠心病慢性心力衰竭患者室性心律失常的疗效。方法 选择2013年7月-2017年8月在喀什地区第一人民医院治疗的245例冠心病慢性心力衰竭室性心律失常患者作为研究对象，根据治疗方法的不同分为对照组（100例）与观察组（145例）。对照组给予胺碘酮治疗，观察组在对照组的基础上给予酒石酸美托洛尔片，两组患者均治疗观察3个月。观察两组患者的临床疗效，比较两组治疗前后的心功能指标、QT离散度（QTd）和不良反应情况。结果 治疗后，观察组的总有效率为99.3%，显著高于对照组的89.0%，两组比较差异具有统计学意义（P<0.05）。治疗后，两组左室射血分数显著升高，左房内径显著降低（P<0.05）；且观察组心功能改善情况显著优于对照组（P<0.05）。治疗后，两组QTd均显著降低（P<0.05），且观察组显著低于对照组（P<0.05）。在治疗期间，两组不良反应发生率分别为2.1%和15.0%，观察组显著低于对照组（P<0.05）。结论 酒石酸美托洛尔片联合胺碘酮治疗冠心病慢性心力衰竭患者室性心律失常具有较好的临床疗效，能改善患者心功能，调节QT离散度，减少不良反应的发生。

Effect of metoprolol combined with amiodarone on ventricular arrhythmias in patients of coronary heart disease with chronic heart failure

Objective To explore the effects of Metoprolol Tartrate Tablets combined with amiodarone in treatment of ventricular arrhythmia in patients of coronary heart disease with chronic heart failure. Methods Patients (245 cases) with ventricular arrhythmia of coronary heart disease with chronic heart failure in The First People''s Hospital of Kashgar Region from July 2013 to August 2017 were divided into control group (100 cases) and observation group (145 cases) according to different treatment methods. The control group were treated with amiodarone, while the observation group were given Metoprolol Tartrate Tablets on the basis of control group, two groups were treated for 3 months. After treatment, clinical efficacies were evaluated, and the cardiac function indexes, QTd, and the adverse reactions in two groups before and after treatment were compared. Results After treatment, the total effective rates of the observation group was 99.3%,which was significantly higher than 89.0% in the control group, and there was difference between two groups (P<0.05). After treatment, the left ventricular ejection fraction in two groups were significantly increased, but left atrial diameter were significantly decreased (P<0.05). And the cardiac function indexes in the observation group were significantly better than those in the control group (P<0.05). After treatment, the QTd in two groups were significantly decreased (P<0.05), and the observation group were lower than that of the control group (P<0.05). During the treatment, the incidence of adverse reactions in two groups were 2.1% and 15%, respectively, and the observation group were lower than control group (P<0.05). Conclusion Metoprolol Tartrate Tablets combined with amiodarone in treatment of ventricular arrhythmia in patients of coronary heart disease with chronic heart failure has a good clinical effect, can improve cardiac function, and regulate QT dispersion, and reduce the incidence of adverse reactions.