美托洛尔联合门冬氨酸钾镁治疗急性冠状动脉综合征合并室性心律失常患者的疗效观察
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摘要
目的探讨美托洛尔联合门冬氨酸钾镁治疗急性冠状动脉综合征(ACS)合并室性心律失常的临床效果。方法选取2017年1月至2019年1月揭阳市人民医院收治的ACS合并室性心律失常患者79例为研究对象,按随机数字表法分为试验组(n=40)和对照组(n=39)。两组患者均予以常规治疗,同时对照组采用美托洛尔、氯化钾治疗,试验组予以美托洛尔联合门冬氨酸钾镁治疗。比较两组患者疗效、不良反应发生率、临床不良事件发生率、治疗前后心电图改善情况。结果试验组治疗的总有效率为95.00%(38/40),较对照组的76.92%(30/39)高(P<0.05);治疗后试验组患者心率、QT离散度小于对照组,QT期间大于对照组(均P<0.05);试验组临床不良事件发生率为2.50%(1/40)、不良反应发生率为12.50%(5/40),与对照组的5.13%(2/39)和10.26%(4/39)比较,差异均无统计学意义(均P>0.05)。结论美托洛尔联合门冬氨酸钾镁不良反应少,能通过改善心电位变化,提高ACS合并室性心律失常的治疗效果,降低临床不良事件发生风险。
Objective To investigate the clinical effect of metoprolol combined with potassium magnesium aspartate in the treatment of acute coronary syndrome(ACS) with ventricular arrhythmia. Methods A total of 79 patients with ACS complicated with ventricular arrhythmia admitted to Jieyang People's Hospital from January 2017 to January 2019 were selected as the research objects, and they were divided into experimental group(n=40) and control group(n=39) according to random number table method.Both groups were given routine treatment, while the control group was treated with metoprolol and potassium chloride, while the experimental group was treated with metoprolol and potassium magnesium aspartate. The curative effect, incidence of adverse reactions, incidence of clinical adverse events, improvement of electrocardiogram before and after treatment were compared between the 2 groups. Results The total effective rate of the experimental group was 95.00%(38/40) higher than 76.92%(30/39)of the control group(P<0.05); after the treatment, the heart rate and QT dispersion of the experimental group were lower than those of the control group, and the QT period was longer than that of the control group(P<0.05); the incidence of clinical adverse events and adverse reactions of the experimental group were 2.50%(1/40) and 12.50%(5/40), respectively, those of the control group were5.13%(2/39) and 10.26%(4/39), respectively. There was no statistically significant difference(P>0.05). Conclusion Metoprolol combined with potassium magnesium aspartate has fewer adverse reactions, can improve the treatment effect of ACS with ventricular arrhythmia by improving cardiac potential changes, and reduce the risk of clinical adverse events.
Objective To investigate the clinical effect of metoprolol combined with potassium magnesium aspartate in the treatment of acute coronary syndrome(ACS) with ventricular arrhythmia. Methods A total of 79 patients with ACS complicated with ventricular arrhythmia admitted to Jieyang People's Hospital from January 2017 to January 2019 were selected as the research objects, and they were divided into experimental group(n=40) and control group(n=39) according to random number table method.Both groups were given routine treatment, while the control group was treated with metoprolol and potassium chloride, while the experimental group was treated with metoprolol and potassium magnesium aspartate. The curative effect, incidence of adverse reactions, incidence of clinical adverse events, improvement of electrocardiogram before and after treatment were compared between the 2 groups. Results The total effective rate of the experimental group was 95.00%(38/40) higher than 76.92%(30/39)of the control group(P<0.05); after the treatment, the heart rate and QT dispersion of the experimental group were lower than those of the control group, and the QT period was longer than that of the control group(P<0.05); the incidence of clinical adverse events and adverse reactions of the experimental group were 2.50%(1/40) and 12.50%(5/40), respectively, those of the control group were5.13%(2/39) and 10.26%(4/39), respectively. There was no statistically significant difference(P>0.05). Conclusion Metoprolol combined with potassium magnesium aspartate has fewer adverse reactions, can improve the treatment effect of ACS with ventricular arrhythmia by improving cardiac potential changes, and reduce the risk of clinical adverse events.
引文
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[2]李莉娟,张冬惠,王绍谦,等.胺碘酮联合美托洛尔治疗冠状动脉粥样硬化性心脏病并发快速心律失常疗效观察[J].新乡医学院学报, 2014, 31(2):120-122.
[3]牛美芝,解静,刘宁,等.门冬氨酸钾镁联合胺碘酮对慢性心力衰竭并室性心律失常患者心功能的影响[J].中国临床保健杂志,2017, 20(4):393-396.
[4]中华医学会心电生理和起搏分会,中国医师协会心律学专业委员会.室性心律失常中国专家共识[J].中国心脏起搏与心电生理杂志, 2016, 30(4):283-325.
[5]杨改宁.胺确酮与门冬氨酸钾镁联合治疗慢性心力衰竭并室性心律失常45例疗效观察[J].陕西医学杂志,2017,46(11):1594-1595.
[6]张静,王平,张岚.急性心肌梗死与心律失常的临床特征分析及胺碘酮联合门冬氨酸钾镁的干预效果观察[J].中国临床医生杂志, 2018, 46(3):282-284.
[7]卓书江,李光智,王转转,等.卡维地洛联合美托洛尔治疗老年高血压合并室性心律失常的疗效及对血清hs-CRP的影响[J].中西医结合心脑血管病杂志, 2018, 16(2):193-195.
[8]肖姗姗,张思雯.自拟平脉定悸方联合硫酸镁对急性冠脉综合征合并顽固性室性心律失常患者炎性反应及24 h动态心电图的影响[J].现代中西医结合杂志, 2017, 26(22):2465-2468.
[9]李敬,李颖,姜瑞博,等.脑心综合征心律失常类型与血浆儿茶酚胺浓度的相关性研究[J].中国医药, 2016, 11(11):1612-1616.