注射用环磷腺苷葡胺联合索他洛尔治疗老年室性心律失常的疗效  

Clinical Effect of Meglumine Adenosine Cyclophosphate for Injection Combined with Sotalol in Treatment of Elderly Ventricular Arrhythmia

作　　者：张龙[1] 郝明辉[1] 黎春光 周瑾 ZHANG Long;HAO Minghui;LI Chunguang;ZHOU Jin(Department of Cardiovascular Medicine,Beijing Luhe Hospital,Capital Medical University,Beijing 101199,China;Laboratory Center,Beijing Luhe Hospital,Capital Medical University,Beijing 101199,China;Department of Medical Affairs,the Eighth Medical Center of PLA,Beijing 100089,China)

机构地区：[1]首都医科大学附属北京潞河医院心血管内科,北京101199 [2]首都医科大学附属北京潞河医院检验中心,北京101199 [3]解放军第八医学中心医务部,北京100089

出　　处：《医学综述》2022年第15期3079-3084,共6页Medical Recapitulate

基　　金：全军医学科技青年培育计划孵化项目(16QNP036)。

摘　　要：目的探讨注射用环磷腺苷葡胺联合索他洛尔治疗老年室性心律失常(VA)的疗效。方法回顾性分析2019年1月至2021年6月首都医科大学附属北京潞河医院收治的105例接受14 d药物治疗的老年VA患者的临床资料,根据治疗药物不同分为对照组(常规药物+索他洛尔治疗,58例)和观察组(常规药物+注射用环磷腺苷葡胺联合索他洛尔治疗,47例),采用倾向性评分匹配评估患者性别、年龄、病程、美国纽约心脏病协会(NYHA)分级基线资料。评估治疗14 d时两组的治疗效果,比较治疗前、治疗14 d时两组的心率变异性(HRV)指标[相邻RR间期差值均方根(RMSSD)、窦性RR间期标准差(SDNN)、RR间期平均值标准差(SDANN)]、炎症指标[肿瘤坏死因子-α(TNF-α)、高敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)]变化,记录并比较治疗期间两组不良反应发生情况。结果采用近邻法进行1∶1匹配,经倾向性评分匹配后,最终两组各纳入30例。治疗14 d时,观察组治疗总有效率高于对照组[96.67%(29/30)比73.33%(22/30)](P<0.05)。治疗前后RMSSD、SDNN、SDANN以及TNF-α、hs-CRP、白细胞介素-6的主效应差异有统计学意义(P<0.01);不考虑测量时间,两组间RMSSD、SDNN、SDANN以及TNF-α、hs-CRP、IL-6的主效应差异有统计学意义(P<0.01);RMSSD、SDNN、SDANN以及TNF-α、hs-CRP、IL-6的时点间与组间存在交互作用(P<0.01),两组治疗前后RMSSD、SDNN、SDANN以及TNF-α、hs-CRP、IL-6的变化幅度不同,观察组变化更明显(P<0.05)。治疗期间,两组总不良反应发生率比较差异无统计学意义(P>0.05)。结论注射用环磷腺苷葡胺联合索他洛尔治疗老年VA的效果显著,可有效改善HRV,减少TNF-α、hs-CRP、IL-6等炎症因子释放,且未增加不良反应发生风险。Objective To investigate the efficacy of meglumine adenosine cyclophosphate for injection combined with sotalol in the treatment of ventricular arrhythmia(VA)in the elderly.Methods The clinical data of 105 elderly VA patients treated with drugs for 14 days in Beijing Luhe Hospital,Capital Medical University from Jan.2019 to Jun.2021 were retrospectively analyzed.According to different therapeutic drugs,they were divided into a control group(conventional drugs+sotalol treatment,58 cases)and an observation group(conventional drugs+meglumine adenosine cyclophosphate for injection combined with sotalol treatment,47 cases).The baseline data of gender,age,course of disease and New York Heart Association(NYHA)classification of patients were evaluated by propensity score matching.The therapeutic effect of the two groups were evaluated after 14 days of treatment,and the heart rate variability(HRV)indexes[the root mean square of successive differences in adjacent RR intervals(RMSSD),standard deviation of NN intervals(SDNN),standard deviation average of NN intervals(SDANN)]and inflammatory indexes[tumor necrosis factor-α(TNF-α),high-sensitivity C-reactive protein(hs-CRP),interleukin-6(IL-6)]were compared between the two groups before treatment and 14 days after treatment,the adverse reactions during treatment of the two groups were recorded and compared.Results The nearest neighbor method was used for 1:1 matching.After propensity score matching,30 cases were included in both groups.After 14 days of treatment,the total effective rate of the observation group was higher than that of the control group[96.67%(29/30)vs 73.33%(22/30)](P<0.05).There were statistically significant differences in the main effects of RMSSD,SDNN,SDANN,TNF-α,hs-CRP and IL-6 before and after treatment(P<0.01);regardless of the measurement time,there were statistically significant differences in the main effects of RMSSD,SDNN,SDANN,TNF-α,hs-CRP and IL-6 between the two groups(P<0.01);there were interactions in RMSSD,SDNN,SDANN,TNF-α,hs-CRP and IL-6

关 键 词：室性心律失常 索他洛尔 注射用环磷腺苷葡胺 心率变异性 炎症 

分 类 号：R541.7[医药卫生—心血管疾病]