胺碘酮和美托洛尔治疗慢性心功能不全合并室性心律失常的疗效分析
Effect Analysis of Amiodarone and Metoprolol in the Treatment of Chronic Cardiac Insufficiency Complicated with Ventricular Arrhythmia

目的：求证并评价胺碘酮和美托洛尔治疗慢性心功能不全合并室性心律失常的疗效。方法：受试对象均为院内2023年1至12月收治的慢性心功能不全合并室性心律失常患者，排除年龄极端/药物过敏/急性心肌梗死/严重瓣膜性心脏病/甲状腺功能异常/近期接受过心脏手术/病态窦房结综合征/二度或三度房室传导阻滞等患者后，选取80例患者入组，经盲法分至对照组(n = 40，仅予以胺碘酮治疗)与研究组(n = 40)，给予胺碘酮和美托洛尔联合治疗。评价两组左心功能评估参数、心肌损伤标志物水平及心输出量与心脏指数水平、心功能分级结果、室性心律失常控制率。结果：较对照组，研究组患者左心室舒张末期及收缩末期内径更小，左心室射血分数更高(P < 0.05)，二尖瓣流速指标改善更为明显(P < 0.05)，提示左心室功能有显著提升；较对照组，研究组患者肌钙蛋白I等心肌损伤标志物水平更低(P < 0.05)，同时心输出量与心脏指数水平更高(P < 0.05)。心功能分级的比较性统计结果显示，较对照组，研究组患者心功能改善显著，I级患者数量更多，III级和IV级患者数量更少(P < 0.05)。此外，较对照组，研究组室性心律失常控制率更高(P < 0.05)。结论：经证实胺碘酮配合美托洛尔形成的联合治疗策略能显著改善慢性心功能不全合并室性心律失常患者左心室功能，降低心肌损伤，提高心输出量与心脏指数，优化心功能分级，并有效控制室性心律失常，具有积极的应用前景。
Objective: To confirm and evaluate the efficacy of amiodarone and metoprolol in the treatment of chronic cardiac insufficiency complicated with ventricular arrhythmia. How: All subjects were patients with chronic cardiac insufficiency complicated with ventricular arrhythmia admitted to the hospital from January to December 2023. After excluding patients with extreme age/drug allergy/acute myocardial infarction/severe valvular heart disease/thyroid dysfunction/recent heart surgery/sick sinus syndrome/second or third degree atrioventricular block, 80 patients were selected into the group. They were divided into control group (n = 40, amiodarone treatment only) and study group (n = 40, amiodarone and metoprolol combined treatment) by blind method. Left ventricular function assessment parameters, myocardial injury markers, cardiac output and cardiac index, cardiac function grading results, and ventricular arrhythmia control rate were evaluated in the two groups. Results: Compared with the control group, the left ventricular diameter at the end of diastolic and systolic period in the study group was smaller, the left ventricular ejection fraction was higher (P < 0.05), and the mitral valve flow rate index was significantly improved (P < 0.05), suggesting that left ventricular function was significantly improved. Compared with the control group, the levels of troponin I and other myocardial injury markers in the study group were lower (P < 0.05), and the levels of cardiac output and cardiac index were higher (P < 0.05). The comparative statistical results of cardiac function classification showed that compared with the control group, the cardiac function of the study group was significantly improved, and the number of grade I