CAJ | 학술논문

目的：探讨曲美他嗪联合宁心宝治疗急性下壁性心肌梗死致缓慢性心律失常的临床疗效和安全性。方法采用随机数字表法对本院心内科2012年2月~2014年1月收治的92例急性下壁性心肌梗死致缓慢性心律失常患者分为研究组和对照组各46例，两组患者均接受抗凝、调酯等常规治疗，对照组在此基础上加用曲美他嗪，研究组加用曲美他嗪、宁心宝治疗，两组患者均治疗2～3个疗程后比较两组患者的临床疗效差异。结果治疗前研究组和对照组的静息状态下心率、最慢心率、平均心率差异无统计学意义（P＞0.05），治疗后研究组静息状态下心率（63.5±4.2）次/min、最慢心率（51.6±4.8）次/min、平均（67.1±4.7）次/min，均显著的优于对照组（P＜0.05）。研究组的心悸、胸闷、头晕或晕厥缓解时间显著的短于对照组（P＜0.05）。治疗前研究组和对照组的生活质量各维度评分差异均无统计学意义（P＞0.05），治疗后两组患者的各维度评分均显著增高（P＜0.05），治疗后研究组的生理职能、身体疼痛、活力、社会功能得分均显著的高于对照组患者（P＜0.05）。研究组患者的临床有效率89.13%显著的高于对照组的69.57%（P＜0.05）。结论曲美他嗪联合宁心宝治疗急性下壁性心肌梗死致缓慢性心律失常能够显著的改善患者的临床症状及生活质量，提高临床疗效。
목적：탐토곡미타진연합저심보치료급성하벽성심기경사치완만성심률실상적림상료효화안전성。방법채용수궤수자표법대본원심내과2012년2월~2014년1월수치적92례급성하벽성심기경사치완만성심률실상환자분위연구조화대조조각46례，량조환자균접수항응、조지등상규치료，대조조재차기출상가용곡미타진，연구조가용곡미타진、저심보치료，량조환자균치료2～3개료정후비교량조환자적림상료효차이。결과치료전연구조화대조조적정식상태하심솔、최만심솔、평균심솔차이무통계학의의（P＞0.05），치료후연구조정식상태하심솔（63.5±4.2）차/min、최만심솔（51.6±4.8）차/min、평균（67.1±4.7）차/min，균현저적우우대조조（P＜0.05）。연구조적심계、흉민、두훈혹훈궐완해시간현저적단우대조조（P＜0.05）。치료전연구조화대조조적생활질량각유도평분차이균무통계학의의（P＞0.05），치료후량조환자적각유도평분균현저증고（P＜0.05），치료후연구조적생리직능、신체동통、활력、사회공능득분균현저적고우대조조환자（P＜0.05）。연구조환자적림상유효솔89.13%현저적고우대조조적69.57%（P＜0.05）。결론곡미타진연합저심보치료급성하벽성심기경사치완만성심률실상능구현저적개선환자적림상증상급생활질량，제고림상료효。
Objective To investigate the clinical efficacy and safety of trimetazidine joint Ningxinbao in treatment of bradycardia induced by acute inferior wall myocardial infarction. Methods 92 cases with acute inferior wall myocardial infarction induced bradycardia treated in cardiology of our hospital from February 2012 to January 2014 were divided into a study group and a control group, with 46 cases in each, both groups received routine treatment such as anticoagulant, adjusting esters, etc., the control group further received trimetazidine, the study group further received Ningxinbao, clinical efficacy of the two groups after treatment for 2 to 3 months were compared. Results The differences of resting state before treatment heart rate, the slowest heart rate, average heart rate between the two groups was not significant (P>0.05), after treatment in the study group, resting heart rate was (63.5±4.2)times/ min, the slowest heart rate was (51.6±4.8)times/min, the average heart rate was (67.1±4.7)times/min , which was significantly better than that in the control group (P < 0.05). In the study Group, palpitations, lightheadedness, dizziness or syncope remission time was significantly shorter than that in the control group (P < 0.05). Before treatment, the quality of life of each dimension scores between the two groups were not significantly different (P>0.05), the two groups after treatment each dimension scores were significantly higher (P<0.05), the physiological functions, the body pain, vitality, social function scores of the study group after treatment were significantly higher (P<0.05). Significant efficiency of clinical study group was 89.13%, higher than that of the control group (69.57%), (P<0.05). Conclusion Trimetazidine joint Ningxinbao treatment of acute inferior wall myocardial infarction induced bradycardia can significantly improve the clinical symptoms and quality of life of patients and improve clinical outcomes.