| Objective: To observe the efficacy of amiodarone combined with metoprolol in the treatment of chronic heart failure complicated with ventricular premature.Methods: A total of 150 patients with chronic cardiac insufficiency combined with premature ventricular beats(PVCS)were selected from January 2016 to December 2018 to be treated in our hospital for clinical study.All patients were divided randomly into three groups,the combination group,the amiodarone group and the metoprolol group,with 50 patients in each group.Routine methods such as vasodilator,diuretic and oxygen inhalation were used for symptomatic treatment of all patients.Patients’ ECG,physiological indications,liver and kidney functions and electrolyte changes were closely observed,and medication was adjusted according to the above indicators.On the basis of the above treatment regimen,the amiodarone group was given oral amiodarone hydrochloride tablets,0.2g each time in the first week,3 times a day,0.2g each time in the second week,2 times a day,and in the third week,0.2g each time,once a day;Oral metoprolol group tartrate metoprolol tablets,1 week 6.25 mg each time,2 times a day,week 2 12.5-25 mg each time,2 times a day,in the second week,starting from week 3,the dosage can be increased to a maximum of 175 mg per day,depending on the patient’s specific situation.In the combined group,amiodarone and metoprolol were taken orally at the same time.In the first week,amiodarone was taken one tablet at a time,3 times a day.In the second to eighth week,the maintenance dosage was changed to 1 tablet at a time,1 time a day.Metoprolol was given at 6.25 mg twice a day in week 1 and 12.5mg twice a day in week 2.The dosage was increased to a maximum of 100 mg per day depending on the patient’s specific situation.To observe the changes of Lee heart failure score,clinical efficacy of heart failure,ventricular number,ventricular early efficacy,interval-associated period,ventricular early index,tp-e interphase,echocardiographic cardiac function,brain natriuretic peptide(BNP)and the occurrence of adverse reactions in each patient after treatment.Results: Three groups of patients before treatment of integral Lee heart failure had no significant difference after treatment were significantly reduced,compared with before treatment group significantly(P<0.05),combination group after treatment of Lee heart failure score was significantly lower than the metoprolol group and amiodarone group,with significant differences between the groups(P< 0.05),metoprolol group and amiodarone group significant differences(P>0.05).The total effective rate was 96% in the combined treatment group,84% in the amiodarone group and 78% in the metoprolol group.The combination group was significantly higher than that of amiodarone group and metoprolol group for the treatment of heart failure,and has a statistically significant difference(P<0.05).24 hour ambulatory electrocardiogram room early number of no significant difference between the three groups of patients before and after treatment were significantly reduced,compared with before treatment group significantly(P<0.05),combination group 24 hours after treatment was significantly lower than the number of dynamic electrocardiogram room early metoprolol group and amiodarone group,with significant differences between the groups(P<0.05),metoprolol group and amiodarone group had no significant difference.Combination group of premature ventricular total efficiency was significantly higher than that of amiodarone group and metoprolol group,and has statistically significant difference(P<0.05).The coupling interval no significant difference between the three groups of patients before treatment,compared before and after treatment,the combination group had significant difference(P<0.05),with statistical difference(P<0.05),metoprolol group and amiodarone group had no difference(P>0.05),combination group was significantly higher than the coupling interval of amiodarone group and metoprolol group,and with statistical difference(P<0.05),but there was no difference between groups in the amiodarone group He Meiruo study group(P>0.05).Three groups of patients before early index had no significant difference,after treatment were significantly increased in combination group and metoprolol group compared with before treatment group significantly(P<0.05),but no significant difference between the amiodarone group(P>0.05),combination group after the treatment of premature ventricular index was significantly higher than that of metoprolol group and amiodarone group,with significant difference between the groups(P<0.05),metoprolol group and amiodarone group had no significant difference(P>0.05).Three groups of patients before treatment TP-e interval had no significant difference after treatment were significantly reduced,compared with before treatment group significantly(P<0.05),combination group after treatment was significantly lower than the TP-e interval of metoprolol group and amiodarone group,with significant differences between the groups(P<0.05),metoprolol group and amiodarone group,no significant difference(P>0.05).The combination group before and after medication echocardiography were significantly improved,and the difference was statistically significant(P<0.05);LVDd improved metoprolol group after treatment(P<0.05),but LVEF,LVFS,LVDs(P>0.05);no significant changes before and after the amiodarone group,all indexes were no significant improvement(P>0.05);from the comparison between the two groups three groups of patients before treatment,each index showed no significant difference(P>0.05),after treatment of combination group,the indicators are better than the metoprolol group,amiodarone group,and has statistically significant difference(P<0.05),but the metoprolol group and amiodarone group compared with no significant difference(P>0.05).Three groups of patients before treatment BNP had no significant difference after treatment were significantly reduced,compared with before treatment group significantly(P<0.05),combined treatment group after treatment BNP was significantly lower than that of metoprolol group and amiodarone group,with significant differences between the groups(P<0.05),metoprolol group and amiodarone group had no significant difference(P>0.05).There were 5 adverse reactions in the combined medication group,the incidence rate was 10%,4 cases in amiodarone group,8% in metoprolol group and 5 in metoprolol group(10%).There was no significant difference in the incidence of adverse reactions between the three groups(P>0.05).All the adverse reactions were mild,temporarily discontinued,or did not stop the use of medication on its own,without any other treatment.Conclusion: 1.Amiodarone combined with metoprolol has a good clinical effect on patients with chronic cardiac insufficiency combined with premature ventricular beats.It can reduce the number of patients with 24-hour PVCS,prolong the interrhythmic period,increase the PVCS index,shorten the TP-E interval,improve the indicators of ultrasonic electrocardiogram and Lee heart failure score of patients,and significantly reduce the BNP level of patients.It is significantly better than amiodarone and metoprolol.2.The dose of amiodarone combined with metoprolol was significantly lower than that of single drug treatment under the condition of good clinical effect.It can significantly reduce the risk of malignant arrhythmia.The incidence and severity of adverse reactions were not increased,and the safety was good. |
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