美托洛尔对DDD型起搏器治疗三度房室传导阻滞患者心功能及QT间期离散度的影响  

Effect of Metoprolol on Cardiac Function and QT Interval Dispersion in Patients with Third-Degree Atrioventricular Block Treated with DDD Pacemaker

作　　者：杨晓 彭海燕[1] 李璐娜 YANG Xiao;PENG Haiyan;LI Luna(Chengdu Third People's Hospital,Sichuan Chengdu 610031,China)

机构地区：[1]四川省成都市第三人民医院CCU,四川成都610031

出　　处：《河北医学》2025年第2期339-344,共6页Hebei Medicine

基　　金：2019年第二批四川省卫生健康科研课题,(编号:19PJ168)。

摘　　要：目的:探究美托洛尔对DDD型起搏器治疗三度房室传导阻滞(AVB)患者心功能及QT间期离散度的影响。方法:回顾性分析2021年1月至2024年1月期间在我院心内科对DDD型起搏器治疗三度AVB患者的临床资料,将术后行常规治疗的患者纳入对照组,将术后在对照组基础上接受美托洛尔的患者纳入观察组,持续用药3个月,采用1∶1最邻近匹配法进行倾向性评分匹配,平衡混杂因素,最终每组63例。比较治疗前和治疗3个月后的心功能[左房内径(LAD)、左室舒张末期内径(LVEDD)、左心室质量指数(LVMI)]、心电图数据(静息心率、平均心率、QT间期离散度)、心脏标志物[血浆脑钠肽(BNP)、肌钙蛋白(cTnI)、肌酸激酶同工酶(CK-MB)],以及记录治疗期间的不良反应发生情况。结果:治疗3个月后,两组患者的LAD、LVEDD、LVMI时限值、静息心率、平均心率、QT间期离散度、BNP、cTnI、CK-MB较治疗前显著降低,但观察组治疗前后差值均高于对照组,差异具有统计学意义(P<0.05)。治疗期间,两组不良反应发生率差异无统计学意义(P>0.05)。结论:美托洛尔能够显著改善接受DDD型起搏器治疗的三度AVB患者患者的心功能和心脏标志物,并优化QT间期离散度,具有较高的安全性。Objective:To explore the effect of metoprolol on cardiac function and QT interval dispersion in patients with third-degree atrioventricular block(AVB)treated with a DDD pacemaker.Methods:A retrospective analysis was conducted on the clinical data of patients with third-degree AVB treated with DDD pacemaker in the cardiology department of our hospital from January 2021 to January 2024.Patients who received routine treatment after surgery were included in the control group,while those who received metoprolol in addition to routine treatment were included in the observation group.Both groups were treated for 3 months.Propensity score matching with a 1∶1 nearest neighbor method was used to balance confounding factors,resulting in 63 patients per group.Cardiac function(left atrial diameter[LAD],left ventricular end-diastolic diameter[LVEDD],left ventricular mass index[LVMI]),electrocardiogram data(resting heart rate,average heart rate,QT interval dispersion),cardiac biomarkers(plasma brain natriuretic peptide[BNP],cardiac troponin I[cTnI],creatine kinase-MB[CK-MB]),and adverse reactions during treatment were compared before and 3 months after treatment.Results:After 3 months of treatment,LAD,LVEDD,LVMI,resting heart rate,average heart rate,QT interval dispersion,BNP,cTnI and CK-MB were significantly reduced compared to before treatment in both groups.The differences between the pre-and post-treatment values in the observation group were greater than those in the control group,with statistically significant differences(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups during the treatment period(P>0.05).Conclusion:Metoprolol significantly improves cardiac function and cardiac biomarkers in patients with third-degree AVB treated with DDD pacemaker,optimizes QT interval dispersion,and demonstrates high safety.

关 键 词：美托洛尔 DDD型起搏器 三度房室传导阻滞 心功能 QT间期离散度 

分 类 号：R541.7[医药卫生—心血管疾病]