摘要
目的:探讨胺碘酮注射液联合琥珀酸美托洛尔缓释片治疗冠心病心绞痛疗效及其对血压(BP)和心率变异性(HRV)的影响。方法:92例冠心病稳定型心绞痛患者根据非随机临床同期对照研究及患者自愿原则分为观察组与对照组,每组各46例。对照组给予琥珀酸美托洛尔+普罗帕酮治疗,观察组给予琥珀酸美托洛尔+胺碘酮注射液治疗。比较治疗5周后两组的临床疗效,入院时与治疗后24 h动态血压、HRV相关指标、QTd水平,入院时与治疗后4周两组患者N末端脑利钠肽前体(NT-proBNP)、脂联素(ANP)、同型半胱氨酸(Hcy)、纤溶酶原液激活剂抑制物-1(PAI-1)水平变化情况。结果:观察组的临床总有效率高于对照组(P<0.05)。治疗后24 h,两组的24 h动态血压[24 h平均收缩压(24 h SBP)、24 h平均舒张压(24 h DBP)、白昼平均收缩压(dSBP)、白昼平均舒张压(dDBP)、夜间平均收缩压(nSBP)、夜间平均舒张压(nDBP)]、QT间期离散度(QTd)均低于入院时,且观察组低于对照组(P<0.05);两组的24 h内全部窦性R-R间期标准差(SDNN)、RR间期差值均方根(RMSSD)、短期时间心跳间期平均标准偏差(SDANN)、24 h R-R间期连续50 ms的百分数(PNN50)均高于入院时,且观察组高于对照组(P<0.05)。出院时,两组患者及血生化相关指标(NT-proBNP、ANP、Hcy、PAI-1)均低于入院时,且观察组低于对照组(P<0.05)。结论:胺碘酮注射液联合琥珀酸美托洛尔缓释片治疗冠心病心绞痛的临床疗效较显著,可稳定心率,降低血压、QTd及血生化相关指标的表达水平,改善预后。
Objective:To investigate the efficacy of amiodarone injection combined with metoprolol succinate sustained-release tablets in the treatment of coronary heart disease with angina pectoris and its influence on blood pressure(BP)and heart rate variability(HRV).Methods:92 patients with coronary heart disease complicated with stable angina pectoris were classified as observation group and control group according to the non-randomized clinical concurrent controlled study and voluntary principle of patients,with 46 cases in each group.The control group received metoprolol succinate+propafenone,and the observation group was given metoprolol succinate+amiodarone injection.The clinical effects of the two groups were compared after 5 weeks of treatment,24h ambulatory blood pressure,HRV related indicators and QTd level at admission and after treatment and levels of N-terminal brain natriuretic peptide(NT-proBNP),adiponectin(ANP),homocysteine(Hcy)and plasminogen activator inhibitor-1(PAI-1)at admission and at 4 weeks after treatment were compared between the two groups.Results:The total clinical effective rate of patients in observation group was obviously increased compared with that in control group(P<0.05).At 24h after treatment,the 24h ambulatory blood pressure indicators 24h mean systolic blood pressure(24 h SBP),24h mean diastolic blood pressure(24 h DBP),daytime mean systolic blood pressure(dSBP),daytime mean diastolic blood pressure(dDBP),nighttime mean systolic blood pressure(nSBP),nighttime mean diastolic blood pressure(nDBP)and QT interval dispersion(QTd)of the two groups of patients were lower than those at admission,and the above indicators were lower in observation group compared with those in control group(P<0.05).The SDNN,RMSSD,SDANN and PNN50 in the two groups of patients were higher than those at admission,and compared with control group,the four indicators of observation group were markedly higher(P<0.05).At discharge,the levels of blood biochemical indicators(NT-proBNP,ANP,Hcy,PAI-1)were lower than those at admission in the two groups of patients,and the levels in observation group were lower compared to control group(P<0.05).Conclusion:Amiodarone injection combined with metoprolol succinate sustained-release tablets has a significant efficacy in the treatment of patients with coronary heart disease complicated with angina pectoris.In addition,it can stabilize heart rate,reduce blood pressure,QTd and blood biochemical related indicators,and improve the clinical symptoms of patients.
作者
吕虎
范从华
左文
LV Hu;FAN Cong-hua;ZUO Wen(Department of Emergency,Xichang People's Hospital,Xichang 615000,Sichuan,China)
出处
《川北医学院学报》
CAS
2021年第10期1329-1333,共5页
Journal of North Sichuan Medical College
基金
四川省医学会专项科研课题(2019TG04)。
关键词
冠心病心绞痛
胺碘酮
美托洛尔
血压
心率变异性
Coronary heart disease with angina pectoris
Amiodarone
Metoprolol
Blood pressure
Heart rate variability
