目的 探討酒石酸美托洛爾片聯(lián)合胺碘酮治療冠心病慢性心力衰竭患者室性心律失常的療效。方法 選擇2013年7月-2017年8月在喀什地區(qū)第一人民醫(yī)院治療的245例冠心病慢性心力衰竭室性心律失常患者作為研究對(duì)象，根據(jù)治療方法的不同分為對(duì)照組（100例）與觀察組（145例）。對(duì)照組給予胺碘酮治療，觀察組在對(duì)照組的基礎(chǔ)上給予酒石酸美托洛爾片，兩組患者均治療觀察3個(gè)月。觀察兩組患者的臨床療效，比較兩組治療前后的心功能指標(biāo)、QT離散度（QTd）和不良反應(yīng)情況。結(jié)果 治療后，觀察組的總有效率為99.3%，顯著高于對(duì)照組的89.0%，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組左室射血分?jǐn)?shù)顯著升高，左房?jī)?nèi)徑顯著降低（P<0.05）；且觀察組心功能改善情況顯著優(yōu)于對(duì)照組（P<0.05）。治療后，兩組QTd均顯著降低（P<0.05），且觀察組顯著低于對(duì)照組（P<0.05）。在治療期間，兩組不良反應(yīng)發(fā)生率分別為2.1%和15.0%，觀察組顯著低于對(duì)照組（P<0.05）。結(jié)論 酒石酸美托洛爾片聯(lián)合胺碘酮治療冠心病慢性心力衰竭患者室性心律失常具有較好的臨床療效，能改善患者心功能，調(diào)節(jié)QT離散度，減少不良反應(yīng)的發(fā)生。

Objective To explore the effects of Metoprolol Tartrate Tablets combined with amiodarone in treatment of ventricular arrhythmia in patients of coronary heart disease with chronic heart failure. Methods Patients (245 cases) with ventricular arrhythmia of coronary heart disease with chronic heart failure in The First People's Hospital of Kashgar Region from July 2013 to August 2017 were divided into control group (100 cases) and observation group (145 cases) according to different treatment methods. The control group were treated with amiodarone, while the observation group were given Metoprolol Tartrate Tablets on the basis of control group, two groups were treated for 3 months. After treatment, clinical efficacies were evaluated, and the cardiac function indexes, QTd, and the adverse reactions in two groups before and after treatment were compared. Results After treatment, the total effective rates of the observation group was 99.3%,which was significantly higher than 89.0% in the control group, and there was difference between two groups (P<0.05). After treatment, the left ventricular ejection fraction in two groups were significantly increased, but left atrial diameter were significantly decreased (P<0.05). And the cardiac function indexes in the observation group were significantly better than those in the control group (P<0.05). After treatment, the QTd in two groups were significantly decreased (P<0.05), and the observation group were lower than that of the control group (P<0.05). During the treatment, the incidence of adverse reactions in two groups were 2.1% and 15%, respectively, and the observation group were lower than control group (P<0.05). Conclusion Metoprolol Tartrate Tablets combined with amiodarone in treatment of ventricular arrhythmia in patients of coronary heart disease with chronic heart failure has a good clinical effect, can improve cardiac function, and regulate QT dispersion, and reduce the incidence of adverse reactions.

自治區(qū)科技支疆項(xiàng)目（2017E0282）