脑心通联合美托洛尔对冠心病合并频发室性早搏的疗效观察  

Curative effect of Naoxintong Capsules combining metoprolol on coronary heart disease complicating frequent premature ventricular contraction

作　　者：邵玲[1] 熊涛[1] 

机构地区：[1]湖北省荆门市第一人民医院心血管内一科,荆门448000

出　　处：《中国循证心血管医学杂志》2015年第2期215-217,共3页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的观察脑心通联合美托洛尔治疗冠状动脉粥样硬化性心脏病(冠心病)合并频发性室性早搏(FPVC)的疗效。方法选自2011年1月至2014年4月冠心病合并FPVC患者168例,随机分为对照组(n=84)和观察组(n=84),两组均行常规治疗,对照组同时予酒石酸美托洛尔片(25 mg,2/日),观察组在对照组基础上加用脑心通胶囊(1.6 g,3/日),观察疗程4周。主要观察终点为患者结局以及FPVC改善情况,结局包括患者症状改善和心脏功能指标的变化,FPVC则通过动态心电图观察早搏次数的变化来评价;次要观察终点为心率变异性(HRV),包括正常N-N间期的标准差(SDNN)、相邻N-N间期差值均方根(RMSSD)、低频功率(LF)和高频功率(HF),同时记录患者不良反应。结果观察期结束后,观察组患者整体疗效更加明显(总体有效率:88.1%vs.75%,P<0.05),左室射血分数提高更显著[(51.6±3.4)%vs.(47.4±4.2)%,P<0.05)],早搏次数明显下降[(427±89)次/24 h vs.(525±114)次/24 h,P<0.05)],HRV结果显示,观察组较对照组改善更为明显,包括SDNN[(133.5±28.4)ms vs.(112.2±17.2)ms],Rmssd[(37.4±9.0)ms vs.(26.8±5.8)ms)]、LF[(530.6±78.0)Hz vs.(445.3±88.0)Hz]、HF[(298.3±54.5)Hz vs.(241.4±36.4)Hz]均明显增加,组间有统计学差异(P均<0.05),观察组与对照组不良反应均为轻度不良反应,且发生率无统计学差异(14.29%vs.10.71%,P=0.484)。结论与美托洛尔单独治疗相比,冠心病合并FPVC患者采用脑心通联合治疗后,治疗效果显著提高,心脏功能改善更加显著,同时能够更好纠正HRV下降,且患者耐受性良好,能够显著提高预后。Objective To observe the curative effect of Naoxintong Capsules combining metoprolol on coronary heart disease （CHD） complicating frequent premature ventricular contraction （FPVC）.Methods The patients with CHD complicating FPVC （n=168） were chosen from Jan. 2011 to Apr. 2014, and then randomly divided into control group and observation group （eachn=84）. On the base of routine treatment, control group was given metoprolol （25 mg, bid） and observation group, Naoxintong Capsules （1.6 g, tid） besides of metoprolol for 4 w. The primary observation endpoint was patients’ outcomes and FPVC amelioration, and outcomes included symptom relief and changes of heart function indexes. FPVC was reviewed through observing on number of premature ventricular contraction （PVC） with Holter. The secondary observation endpoint was heart rate variability （HRV） and adverse reactions.Results At the end of observation course, the overall effect was more significant （88.1%vs. 75%,P〈0.05）, LVEF increased more significantly [（51.6±3.4）%vs. （47.4±4.2）%,P〈0.05], and number of PVC decreased significantly [（427±89） times/24hvs. （525±114） times/24h,P〈0.05] in observation group compared with control group. The results of observing HRV showed that HRV amelioration was more significant in observation group compared with control group including SDNN [（133.5±28.4） msvs. （112.2±17.2） ms], Rmssd [（37.4±9.0） msvs. （26.8±5.8） ms）], LF [（530.6±78.0） Hzvs. （445.3±88.0） Hz] and HF [（298.3±54.5） Hzvs. （241.4±36.4） Hz, allP〈0.05]. The adverse reactions were all mild and the incidence had no statistical difference between 2 groups （14.29%vs. 10.71%,P=0.484）.Conclusion In patients with CHD complicating FPVC, metoprolol combining Naoxintong Capsules improves significantly heart function and corrects HRV decrease, which was well tolerated by patients, and promises prognosis compared metoprolol monotherapy,.

关 键 词：脑心通胶囊 美托洛尔 冠心病 频发性室性早搏 心率变异性 

分 类 号：R541.4[医药卫生—心血管疾病]