[关键词]
[摘要]
目的 探讨参仙升脉口服液联合盐酸尼非卡兰治疗室性心律失常的临床疗效。方法 回顾性分析2018年12月—2020年12月在平顶山市第一人民医院进行治疗的52例室性心律失常患者为研究对象,根据用药差别将所有患者分为治疗组和对照组,每组各26例。对照组给予注射用盐酸尼非卡兰,0.3 mg/kg,溶入0.9%氯化钠注射液20 mL中,在连续心电监护下,5 min内注射完毕;治疗组在对照组基础上口服参仙升脉口服液,20 mL/次,2次/d。两组均治疗2周进行效果对比。观察两组的临床疗效,比较两组心率变异性指标、心电图指标和血清学指标。结果 经治疗,治疗组患者总有效率是96.15%,显著高于对照组的80.77%(P<0.05)。经治疗,两组所有正常RR间期的标准差(SDNN)、全程每5 min NN节段窦性RR间期标准差(SDANN)及全程相邻RR之差的均方根(rMSSD)均较治疗前显著升高(P<0.05),且治疗组改善更显著(P<0.05)。经治疗,两组QT散度(QTd)较治疗前显著降低,但QT间期最小值(QTmin)、矫正的QT间期(QTc)均显著升高(P<0.05),且治疗组心电图指标改善优于对照组(P<0.05)。经治疗,两组血清同型半胱氨酸(Hcy)、心肌肌钙蛋白I(cTnI)、N末端B型脑钠肽(NT-proBNP)、肌酸激酶同工酶(CK-MB)水平均较治疗前显著降低(P<0.05),且治疗后治疗组降低更加显著(P<0.05)。结论 参仙升脉口服液联合盐酸尼非卡兰治疗室性心律失常具有较好的临床疗效,可有效改善患者心率变异性,改善心电图指标及血清细胞因子水平,有着良好临床应用价值。
[Key word]
[Abstract]
Objective To investigate the clinical efficacy of Shenxian Shengmai Oral Liquid combined with nifekalant hydrochloride in treatment of ventricular arrhythmia.Methods Fifty-two patients with ventricular arrhythmia treated in Pingdingshan First People's Hospital from December 2018 to December 2020 were retrospectively analyzed. All patients were divided into treatment group and control group according to medication difference, with 26 patients in each group. Patients in the control group were given Nifekalan Hydrochloride for injection, 0.3 mg/kg, dissolved into 0.9% sodium chloride injection 20 mL, and the injection was completed within 5 min under continuous ECG monitoring. Patients in the treatment group were po administered with Shenxian Shengmai Oral Liquid on the basis of the control group, 20 mL/time, twice daily. The two groups were treated for 2 weeks. The clinical efficacy of the two groups was observed, and the heart rate variability, electrocardiogram and serological indexes were compared between the two groups.Results After treatment, the total effective rate of treatment group was 96.15%, significantly higher than that of control group 80.77% (P < 0.05). After treatment, the standard deviation of all normal RR intervals (SDNN), the standard deviation of segmental sinus RR intervals (SDANN) and the root mean square of difference between adjacent RR intervals (rMSSD) were significantly increased in two groups compared with before treatment (P < 0.05), and the improvement was more significant in the treatment group (P < 0.05). After treatment, the QT dispersion (QTd) in both groups was significantly decreased compared with before treatment, but the minimum QT interval (QTmin) and corrected QT interval (QTc) were significantly increased (P < 0.05), and the ECG index improvement in treatment group was better than that in control group (P < 0.05). After treatment, the levels of serum homocysteine (Hcy), cardiac troponin I (cTnI), N-terminal B-type brain natriuretic peptide (NT-probNP) and creatine kinase isoenzyme (CK-MB) in two groups were significantly decreased compared with before treatment (P < 0.05), and the decrease was more significant after treatment (P < 0.05).Conclusion Shenxian Shengmai Oral Liquid combined with nifekalant hydrochloride has good clinical effect in treatment of ventricular arrhythmia, and can effectively improve patients' heart rate variability, ECG indexes and serum cytokine level, which has good clinical application value.
[中图分类号]
R972
[基金项目]
河南省科技攻关项目(LHGJ20141851)