CAJ | 학술논문

目的：探究小剂量胺碘酮联合倍他乐克治疗肥厚型心肌病伴恶性室性心律失常临床疗效。方法将108例肥厚型心肌病伴恶性室性心律失常患者随机平均分成三组：胺碘酮组（口服胺碘酮）、倍他乐克组（口服倍他乐克）和联合用药组（同时口服胺碘酮和倍他乐克）。根据治疗前后1周的动态心电图检测结果评价三组疗效，统计治疗前后动态心电图QTd值变化情况和的疗效评价结果。结果治疗前三组QTd值无差异，治疗后小剂量胺碘酮联合倍他乐克用药组的QTd值和改善值均明显高于胺碘酮组和倍他乐克组；小剂量胺碘酮联合倍他乐克用药组的总有效率为94.44%，明显高于胺碘酮组的77.78%和倍他乐克组的80.55%，差异具有统计学意义（ P <0.05）。结论胺碘酮和倍他乐克两药合用的药效明显大于单独用药，这对于临床治疗肥厚型心肌病伴恶性室性心律失常将有重要的指导意义。
목적：탐구소제량알전동연합배타악극치료비후형심기병반악성실성심률실상림상료효。방법장108례비후형심기병반악성실성심률실상환자수궤평균분성삼조：알전동조（구복알전동）、배타악극조（구복배타악극）화연합용약조（동시구복알전동화배타악극）。근거치료전후1주적동태심전도검측결과평개삼조료효，통계치료전후동태심전도QTd치변화정황화적료효평개결과。결과치료전삼조QTd치무차이，치료후소제량알전동연합배타악극용약조적QTd치화개선치균명현고우알전동조화배타악극조；소제량알전동연합배타악극용약조적총유효솔위94.44%，명현고우알전동조적77.78%화배타악극조적80.55%，차이구유통계학의의（ P <0.05）。결론알전동화배타악극량약합용적약효명현대우단독용약，저대우림상치료비후형심기병반악성실성심률실상장유중요적지도의의。
Objective To explore the efficacy of small dosage of amiodarone combined with metoprolol in treatment of hypertrophic cardio-myopathy associated with malignant ventricular arrhythmia,and to provide the reference for clinical treatment. Methods A total of 108 cases of hypertrophic cardiomyopathy were selected for this study. They were randomly divided into three groups( amiodarone group,metoprolol group and combination group),according to different methods of treatment,their efficacy including evaluation of dynamic electrocardiogram examination be-fore and after treatment for 1 week and results of changes in QTd of dynamic electrocardiogram before and after treatment were compared. Results There was no difference in QTd value in 3 groups before treatment. After treatment with small dosage of amiodarone combined with metoprolol, QTd value and improvement value in combination group were significantly lower than those of amiodarone group and metoprolol group;the total ef-fectiveness of combination group was 94. 44%,it was significantly higher than that of amiodarone group(77. 78%)and betaloc group(80. 55%);and the difference was statistically significant. Conclusion The efficacy of combined amiodarone and metoprolol was significantly higher than that of the drug used alone,and this application will have important guiding significance in clinical treatment of hypertrophic cardiomyopathy associated with malignant ventricular arrhythmia.