厄贝沙坦联合美托洛尔治疗慢性心力衰竭合并房性或室性心律失常患者的疗效

摘要

目的 探讨厄贝沙坦联合美托洛尔治疗慢性心力衰竭(CHF)合并房性或室性心律失常患者的疗效.方法 2017年于我院接受治疗的CHF合并房性或室性心律失常患者168例被随机均分为美托洛尔组(在常规治疗基础上接受美托洛尔)和联合治疗组(在美托洛尔组基础上加用厄贝沙坦),两组均治疗3个月.观察比较两组治疗前后LVEF 、左室后壁厚度(LVPWT) 、室间隔厚度(IVST) 、临床疗效.结果 联合治疗组治疗总有效率显著高于美托洛尔组(90.5% 比73.8%) , P＝0.005 .与治疗前比较,联合治疗组治疗后LVEF[(55. 16 ± 6.52)% 比(64. 24 ± 8.72)%]显著升高,LVPWT[(14.72 ± 1.78)mm比(13.27 ± 1.14)mm]和IVST[(10.18 ± 1.15)mm比(9.12 ± 0.64) mm]显著减小,P均＝0. 001 ;且与美托洛尔组比较LVEF [(56.13 ± 6. 15)% 比(64. 24 ± 8.72)%]升高更显著,LVP‐WT[(14.35 ± 1.23)mm比(13.27 ± 1.14)mm]和IVST [(9.88 ± 0.85) mm比(9.12 ± 0.64)mm]减小更显著,P均＝0.001 .两组药物不良反应率无显著差异,P＝0.799 .结论 厄贝沙坦联合美托洛尔治疗慢性心力衰竭合并房性和室性心律失常疗效显著,安全.对于心室重构的抑制作用可能是其主要机制.%To explore therapeutic effect of irbesartan combined metoprolol on patients with chronic heart failure (CHF) complicated atrial or ventricular arrhythmia .Methods : A total of 168 CHF patients with atrial or ventricular arrhythmia treated in our hospital from 2017 were randomly and equally divided into metoprolol group (re‐ceived metoprolol based on routine treatment ) and combined treatment group (received irbesartan based on metoprolol group) , both groups were treated for three months .LVEF , left ventricular posterior wall thickness (LVPWT) , interven‐tricular septal thickness (IVST) before and after treatment , therapeutic effect were observed and compared between two groups.Results : Total effective rate of combined treatment group was significantly higher than that of metoprolol group (90.5% vs.73.8%) , P＝ 0.005. Compared with before treatment , there was significant rise in LVEF [ (55.16 ± 6.52)% vs.(64.24 ± 8.72)%] , and significant reductions in LVPWT [ (14.72 ± 1.78) mm vs.(13.27 ± 1.14) mm] , IVST [ (10.18 ± 1.15) mm vs.(9.12 ± 0.64) mm] in combined treatment group after treatment , P＝0.001 all ;and compared with metoprolol group after three‐month treatment , there was significant rise in LVEF [ (56.13 ± 6.15)%vs.(64. 24 ± 8.72)%] , and significant reductions in LVPWT [ (14. 35 ± 1. 23) mm vs.(13.27 ± 1.14) mm] and IVST [(9. 88 ± 0.85) mm vs.(9. 12 ± 0. 64) mm] in combined treatment group , P＝0. 001 all.There was no signif‐icant difference in incidence rate of adverse between two groups , P＝ 0.799. Conclusion : Irbesartan combined metoprolol possess significant therapeutic effect on patients with CHF complicated atrial or ventricular arrhythmia with good safety .Inhibition on ventricular remodeling may be its main mechanism .