丹红注射液联合酒石酸美托洛尔对冠心病心律失常患者血流动力学及心电图的影响

摘要

目的:分析丹红注射液联合酒石酸美托洛尔对冠心病心律失常患者血流动力学及心电图的影响.方法:选择2013年2月至2016年9月于我院接受治疗的98例冠心病心律失常患者.根据随机数字表法,患者被随机均分为常规治疗组和联合治疗组(在常规治疗组基础上加用丹红注射液联合酒石酸美托洛尔),两组均连续治疗4周.观察比较两组治疗前后血压等指标和疗效.结果:与治疗前比较,治疗4周后两组收缩压(SBP) 、舒张压(DBP) 、平均动脉压(MAP) 、短阵室速次数、室性早搏次数、红细胞沉降率(ESR ) 、纤维蛋白原(Fg ) 、红细胞比容(HCT) 、全血低切黏度(NBL)和全血高切黏度(NBH)均显著降低, PR间期显著延长,联合治疗组QT间期显著延长( P＜0.05或＜ 0. 01 ) .与常规治疗组比较,联合治疗组治疗4周后SBP [ (120.11 ± 10. 23 ) mmHg比(108.11 ± 7.83) mmHg]、 DBP [ (85.61 ± 5.61) mmHg比(70.12 ± 4.12) mmHg]、 MAP [ (100.11 ± 7.23) mmHg比(81.33 ± 5.16) mmHg]、短阵室速次数 [ (4.51 ± 0.31)次/d比(2.11 ± 0.25)次/d]、室早次数[ (3673.11 ± 86.34)次/d比(2711.34 ± 62.31)次/d]、 ESR [ (19.72 ± 2.73) mm/h比(12.44 ± 1.98) mm/h]、Fg [ (300.11 ± 23.44 ) g/L比(223.43 ± 16.74 ) g/L] 、 HCT [ (40.12 ± 3.57 )% 比(31. 32 ± 2. 14 )% ] 、 NBL [(8.22 ± 1.11) mpa·s比(6.72 ± 0.84) mpa·s] 和NBH [(5.12 ± 0.73) mpa·s比(3.98 ± 0.56) mpa·s] 降低更显著,QT间期 [ (0.38 ± 0.17) s比(0.49 ± 0.19) s]、 PR间期 [ (0.17 ± 0.02) s比(0.19 ± 0.03) s] 和QRS时限 [ (0.07 ± 0.02) s比(0.09 ± 0.03) s] 延长更显著, P均＜0.01 .联合治疗组治疗总有效率显著高于常规治疗组(89.80% 比73.47%) , P＝0.035 .结论:丹红注射液联合酒石酸美托洛尔能显著改善冠心病心律失常患者血流动力学和心电图指标,值得推广.%Objective :To analyze influence of Danhong injection combined metoprolol tartrate on hemodynamics and ECG in patients with coronary heart disease (CHD) and arrhythmias .Methods :A total of 98 CHD patients with ar-rhythmias treated in our hospital from Feb 2013 to Sep 2016 were selected .The patients were randomly divided into routine treatment group and combined treatment group (received Danhong injection combined metoprolol tartrate based on routine treatment group ) ,both groups were treated for continuous four weeks .Blood pressure etc .indexes and therapeutic effect were observed and compared between two groups before and after treatment .Results : Com-pared with before treatment ,after four-week treatment ,there were significant reductions in systolic blood pressure (SBP) ,diastolic blood pressure (DBP) ,mean arterial pressure (MAP) ,times of non-sustained ventricular tachycar-dia (NSVT) and ventricular premature beat (VPB) ,erythrocyte sedimentation rate (ESR) ,fibrinogen (Fg) ,hem-atocrit (HCT) ,whole blood low shear viscosity (NBL) and whole blood high shear viscosity (NBH) ,and significant rise in PR interval in two groups ,and significant rise in QT interval in combined treatment group , P＜0. 05 or ＜0.01. Compared with routine treatment group after four-week treatment ,there were significant reductions in levels of SBP [ (120.11 ± 10.23) mmHg vs.(108.11 ± 7.83) mmHg] ,DBP [ (85.61 ± 5.61) mmHg vs.(70.12 ± 4.12) mmHg] ,MAP [ (100.11 ± 7.23) mmHg vs .(81.33 ± 5.16) mmHg] ,times of NSVT [ (4.51 ± 0.31) times/d vs. (2.11 ± 0.25) times/d] and VPB [ (3673.11 ± 86.34) times/d vs.(2711.34 ± 62.31) times/d] ,ESR [ (19.72 ± 2.73) mm/h vs.(12.44 ± 1.98) mm/h] ,Fg [ (300.11 ± 23.44) g/L vs.(223.43 ± 16.74) g/L] ,HCT [ (40.12 ± 3.57)% vs.(31.32 ± 2.14)% ] ,NBL [ (8.22 ± 1.11) mpa·s vs .(6.72 ± 0.84) mpa·s] and NBH [ (5.12 ± 0.73) mpa·s vs .(3.98 ± 0.56) mpa·s] ,and significant rise in QT interval [ (0.38 ± 0.17) s vs .(0.49 ± 0.19) s] ,PR interval [ (0.17 ± 0.02) s vs.(0.19 ± 0.03) s] and QRS interval [ (0.07 ± 0.02) s vs.(0.09 ± 0.03) s] in combined treatment group , P＜0. 01 all.Total effective rate of combined treatment group was significantly higher than that of routine treatment group (89.80% vs.73.47%) , P＝0.035 .Conclusion :Danhong injection combined metoprolol tartrate can significantly improve hemodynamic and ECG indexes in CHD patients with arrhythmias , which is worth extending .