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目的探讨胺碘酮联合美托洛尔对老年冠心病合并心律失常患者超声指标及预后的影响。方法选择2012年5月~2015年1月老年冠心病合并心律失常患者80例为研究对象,根据入院时间先后顺序随机分为观察组42例和对照组38例,观察组患者接受胺碘酮联合美托洛尔治疗,对照组患者接受胺碘酮治疗,比较两组患者心绞痛的发作情况、心功能情况、血清炎性因子含量、治疗效率。结果临床疗效:观察组显效有效率92.86%明显高于对照组76.32%(χ~2=4.281,p<0.05);心绞痛发作情况:观察组心绞痛发作次数、硝酸甘油服用数量均明显低于对照组(1.58±0.25 vs 2.29±0.42,1.79±0.31 vs 2.42±0.48)(t=9.290,7.039,p<0.05);超声指标:观察组左心室舒张末期内径(LVDD)、左心室收缩末内径(LVSD)均明显低于对照组(52.58±6.15vs 57.91±6.62,40.59±4.75 vs 45.88±5.14)mm(t=3.733,4.784,p<0.05),左心室射血分数(LVEF)、左室短轴缩短率(LVSF)均明显高于对照组(54.14±6.24 vs 48.42±5.56,53.49±5.91 vs 49.71±4.94)%(t=4.310,3.086,p<0.05);炎性因子:观察组血清中C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)的含量均明显低于对照组[4.21±0.65vs6.35±0.85)mg/L,(0.52±0.15 vs 0.87±0.32)ng/L,(6.49±0.78 vs 8.35±1.02)ng/L](t=12.718,6.361,9.212,p<0.05)。结论胺碘酮联合美托洛尔能够减少心绞痛的发作,改善心功能,减轻炎症反应程度,提高治疗效果。
Objective To investigate the effect of amiodarone combined with metoprolol on the ultrasonic parameters and prognosis of elderly patients with coronary heart disease complicated with arrhythmia. Methods From May 2012 to January 2015, 80 elderly patients with coronary heart disease complicated with arrhythmia were selected as the study subjects. They were randomly divided into observation group (n = 42) and control group (n = 38) according to the order of admission. Patients in observation group received amiodarone combined Metoprolol treatment, patients in the control group received amiodarone treatment, angina pectoris seizures, cardiac function, serum inflammatory cytokines content, treatment efficiency were compared between the two groups. Results Clinical effect: The effective rate of observation group was 92.86%, significantly higher than 76.32% of control group (χ ~ 2 = 4.281, p <0.05). The incidence of angina pectoris: The number of angina pectoris and the dosage of nitroglycerin in observation group were significantly lower than those in control group (1.58 ± 0.25 vs 2.29 ± 0.42,1.79 ± 0.31 vs 2.42 ± 0.48 respectively) (t = 9.290, 7.039, p <0.05). The indexes of ultrasonography included left ventricular end diastolic diameter (LVDD), left ventricular end systolic diameter ) Were significantly lower than those in the control group (52.58 ± 6.15 vs 57.91 ± 6.62, 40.59 ± 4.75 vs 45.88 ± 5.14 mm, t = 3.733, 4.784, p <0.05), left ventricular ejection fraction (54.14 ± 6.24 vs 48.42 ± 5.56, 53.49 ± 5.91 vs 49.71 ± 4.94)%, respectively (t = 4.310, 3.086, p <0.05). Inflammatory factor: The level of C The contents of CRP, TNF-α and IL-6 were significantly lower than those of the control group [4.21 ± 0.65 vs6.35 ± 0.85 mg / L, ( 0.52 ± 0.15 vs 0.87 ± 0.32 ng / L, (6.49 ± 0.78 vs 8.35 ± 1.02) ng / L] (t = 12.718, 6.361, 9.212, p <0.05). Conclusion Amiodarone combined with metoprolol can reduce the incidence of angina pectoris, improve cardiac function, reduce the degree of inflammatory reaction and improve the therapeutic effect.