摘要
目的探究与分析参松养心胶囊联合美托洛尔治疗冠状动脉粥样硬化性心脏病合并心律失常的临床效果。方法选取2017年6月至2019年6月台儿庄区人民医院内科收治的110例冠状动脉粥样硬化性心脏病合并心律失常患者,男60例,女50例,年龄(59.11±12.74)岁,年龄范围为42~73岁。采用随机数表法将患者随机分为美托洛尔组与联合治疗组,每组55例。联合治疗组予以参松养心胶囊和美托洛尔联合治疗,美托洛尔组应用美托洛尔治疗,连续治疗4周,比较两组患者在治疗前后的临床效果、心功能指标、心率达标时间、心房颤动患者心率达标率、24 h室性早搏次数、血脂指标、血浆B型脑利钠肽(BNP)水平及不良反应发生率。结果联合治疗组有效率[90.9%(50/55)]高于美托洛尔组[74.5%(41/55)],差异有统计学意义(P<0.05)。治疗后联合治疗组心率达标时间[(22.36±3.74)d]短于美托洛尔组[(23.05±4.25)d]、心房颤动患者心率达标率[25.5%(14/55)]高于美托洛尔组[21.8%(12/55)]、24 h室性早搏次数[(296.68±20.77)次]少于美托洛尔组[(300.96±22.75)次];左心室收缩末期内径[(35.42±9.75)mm]、左心室舒张末期内径[(45.76±5.37)mm]低于美托洛尔组[(41.63±8.54)mm、(50.76±6.22)mm],左心室射血分数[(44.73±8.61)%]、心脏指数[(3.35±0.67)L/min·m2]高于美托洛尔组[(39.18±8.22)%、(2.94±0.82)L/min·m2];甘油三酯[(1.31±0.33)mmol/L]、总胆固醇[(4.15±1.27)mmol/L]、低密度脂蛋白胆固醇[(3.12±0.36)mmol/L]、BNP[(89.54±28.77)ng/L]低于美托洛尔组[(1.48±0.45)mmol/L、(5.16±1.73)mmol/L、(3.75±0.43)mmol/L、(125.63±30.01)ng/L],高密度脂蛋白胆固醇[(1.57±0.42)mmol/L]较美托洛尔组[(1.29±0.38)mmol/L]高,差异均有统计学意义(P<0.05)。结论参松养心胶囊联合美托洛尔治疗冠状动脉粥样硬化性心脏病心律失常患者可明显改善心功能,纠正心律失常,调节血脂及血浆BNP的水平,且期间不增加并发症发生率,安全性较高。
Objective To investigate and analyze the clinical effect of Shensong Yangxin Capsule combined with metoprolol in the treatment of coronary artery disease complicated with arrhythmia.Methods A retrospective study was performed on 110 cases of patients with coronary artery disease complicated with arrhythmia who were admitted in the Department of Internal Medicine of Zaozhuang Taierzhuang District People′s Hospital from June 2017 to June 2019,60 males and 50 females,aged(59.11±12.74)years old,ranging from 42 to 73 years old.The patients were randomly divided into the metoprolol group and the combined treatment group,with 55 patients in each group.The combined treatment group of patients were treated the Shensong Yangxin Capsule combined with metoprolol,the metoprolol group of patients were treated with metoprolol.After continuous treatment for 4 weeks,the clinical effect,cardiac function index,fast heart rate reaching the standard time,heart rate reaching the standard rate,ventricular premature beats at 24 hours,blood lipid index,plasma B-type brain natriuretic peptide(BNP)level and the incidence of adverse reactions in the two groups were compared before and after treatment.Results The effective rate of the combined treatment group[90.9%(50/55)]was higher than that of the metoprolol group[74.5%(41/55)],and the difference was statistically significant(P<0.05).After treatment,the fast heart rate of the combined treatment group[(22.36±3.74)days]was shorter than that of the metoprolol group[(23.05±4.25)days],the heart rate of patients with atrial fibrillation[25.5%(14/55)]was higher than that of the metoprolol group[21.8%(12/55)],and the number of ventricular premature beats at 24 hours[(296.68±20.77)times]was lower than that of the metoprolol group[(300.96±22.75)times].The end-left ventricular systolic diameter[(35.42±9.75)mm],end-left ventricular diastolic diameter[(45.76±5.37)mm]were lower than those in the metoprolol group[(41.63±8.54)mm,(50.76±6.22)mm],the left ventricular ejection fraction[(44.73±8.61)%],and the cardiac index[(3.35±0.67)L/min·m2]were higher than those in the metoprolol group[(39.18±8.22)%,(2.94±0.82)L/min·m2].Triglycerides[(1.31±0.33)mmol/L],total cholesterol[(4.15±1.27)mmol/L],LDL cholesterol[(3.12±0.36)mmol/L],BNP[(89.54±28.77)ng/L]of the combined treatment group were lower than those of the metoprolol group[(1.48±0.45)mmol/L,(5.16±1.73)mmol/L,(3.75±0.43)mmol/L,(125.63±30.01)ng/L].High-density lipoprotein cholesterol[(1.57±0.42)mmol/L]was higher than that in the metoprolol group[(1.29±0.38)mmol/L],and the differences were statistically significant(P<0.05).Conclusion Shensong Yangxin Capsule combined with metoprolol can significantly improve cardiac function,correct arrhythmia,regulate blood lipids and plasma BNP levels in patients with coronary heart disease arrhythmia,and it does not increase the incidence of complications during the period,and has higher safety.
作者
梁敏
刘勇
田思念
Liang Min;Liu Yong;Tian Sinian(Fourth Department of Internal Medicine,Zaozhuang Taierzhuang District People′s Hospital,Zaozhuang 277400,China;Second Department of Internal Medicine,Zaozhuang Taierzhuang District People′s Hospital,Zaozhuang 277400,China;Department of Cardiology,Zaozhuang Taierzhuang District People′s Hospital,Zaozhuang 277400,China)
出处
《中国临床实用医学》
2020年第3期24-28,共5页
China Clinical Practical Medicine
