目的 探讨复方丹参滴丸联合普罗帕酮治疗室性心律失常的临床疗效。方法 回顾性分析2020年1月—2021年6月在河北大学附属医院进行治疗的300例室性心律失常患者的临床资料，根据用药差别分成对照组和治疗组，每组各150例。对照组口服盐酸普罗帕酮片，150 mg/次，4次/d；治疗组在对照组治疗基础上口服复方丹参滴丸，10丸/次，3次/d。两组连续治疗2周。观察两组的临床疗效，比较两组心率变异性指标、相关量表评分、心电图指标和血清学指标的变化情况。结果 治疗后，治疗组总有效率是98.67%，显著高于对照组的85.33%（P＜0.05）。治疗后，两组全程每5分钟NN节段窦性RR间期标准差（SDANN）、RR间期的标准差（SDNN）、全程相邻RR之差的均方根（RMSSD）值、差值大于50 ms RR间期与心动周期次数的比值（PNN50）均较治疗前显著升高（P＜0.05）；并以治疗组改善更明显（P＜0.05）。治疗后，两组改良Barthel指数（MBI）评分、生活质量综合评定问卷-74（GQOL-74）评分均显著升高（P＜0.05），并以治疗组改善更明显（P＜0.05）。治疗后，两组心电图QT散度（QTd）较治疗前显著降低，而QT间期最小值（QTmin）、矫正的QT间期（QTc）均显著提高（P＜0.05），并以治疗组改善最为明显（P＜0.05）。经治疗，两组患者血清同型半胱氨酸（Hcy）、可溶性CD40配体（CD40L）、肿瘤坏死因子-α（TNF-α）、半乳糖凝集素-3（Gal-3）、肌酸激酶同工酶（CK-MB）水平均较治疗前显著降低（P＜0.05），并以治疗组降低更明显（P＜0.05）。结论 复方丹参滴丸联合普罗帕酮治疗室性心律失常具有较好的临床疗效，能够改善患者心率变异性和细胞因子，有利于提高患者生活质量，有着良好的临床应用价值。

Objective To explore the clinical efficacy of Compound Danshen Dropping Pills combined with propafenone in treatment of ventricular arrhythmias. Methods The clinical data of 300 patients with ventricular arrhythmia treated in Affiliated Hospital of Hebei University from January 2020 to June 2021 were retrospectively analyzed. According to the difference of medication, they were divided into control group and treatment group, with 150 cases in each group. Patients in the control group were po administered with Propafenone Hydrochloride Tablets, 150 mg/time, four times daily. Patients in the control group were po administered with Compound Danshen Dropping Pills on the basis of the control group, 10 pills/time, three times daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacy was evaluated, and the changes of heart rate variability, related scale scores, electrocardiogram and serological indexes were compared between the two groups. Results After treatment, the total effective rate in the treatment group was 98.67%, significantly higher than 85.33% in the control group (P < 0.05). After treatment, the standard deviation of NN segment sinus RR interval (SDANN), standard deviation of RR interval (SDNN), root mean square (RMSSD) value of the difference between adjacent RR intervals and the ratio of RR interval to cardiac cycle number (PNN50) over 50 ms were significantly increased in both groups compared with before treatment (P < 0.05). The improvement was more obvious in the treatment group (P < 0.05). After treatment, the improved Barthel index (MBI) score and quality of life Questionnaire (GQOL-74) score in both groups were significantly increased (P < 0.05), and the improvement was more obvious in the treatment group (P < 0.05). After treatment, the ECG QT dispersion (QTd) of two groups was significantly decreased compared with before treatment, while the minimum QT interval (QTmin) and corrected QT interval (QTc) were significantly increased (P < 0.05), and the improvement was most obvious in the treatment group (P < 0.05). After treatment, the serum levels of homocysteine (Hcy), soluble CD40 ligand (CD40L), tumor necrosis factor -α (TNF-α), galactose lectin-3 (Gal-3), and creatine kinase isoenzyme (CK-MB) in two groups were significantly decreased compared with before treatment (P < 0.05), and the decrease was more obvious in the treatment group (P < 0.05). Conclusion Compound Danshen Dropping Pills combined with propafenonehas good clinical effect in treatment of ventricular arrhythmias, and can improve heart rate variability and cytokines, and is beneficial to improve patients' life quality, which has good clinical application value.

R972

保定市科技计划项目(2041ZF312)