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目的:观察β-受体阻滞剂倍他乐克联合起搏器植入对长QT综合征(LQTS)并发尖端扭转性室速(Td P)的临床疗效。方法:45例LQTS并发Td P患者根据治疗意愿分为两组,对照组22例采用心脏永久性起搏器植入治疗,观察组23例采用倍他乐克联合心脏永久性起搏器植入治疗。比较两组患者治疗效果及治疗前后晕厥发作次数、校正后Q-T间期(QTc)、左室射血分数(LVEF)、心脏事件年发生次数、Td P发作频率和持续时间。结果:观察组患者治疗总有效率(82.6%)明显高于对照组(68.2%)(P<0.05);两组患者治疗后晕厥年发作次数、QTc、心脏事件年发生次数、Td P发作频率和Td P发作持续时间均明显降低(P<0.05),且观察组降低更为显著(P<0.05),而两组LVEF比较差异无统计学意义(P>0.05)。结论:β-受体阻滞剂倍他乐克联合起搏器植入对LQTS并发Td P疗效显著,值得临床推广应用。
Objective: To observe the clinical efficacy of β-receptor blocker Betaloke combined with pacemaker implantation in the treatment of long QT syndrome (LQTS) complicated with torsades de pointes (Td P). Methods: Forty-five patients with LQTS complicated with Td P were divided into two groups according to the intention of treatment. Twenty-two patients in the control group were treated with permanent cardiac pacemaker implantation. 23 patients in the observation group were treated with metoprolol combined with permanent cardiac pacemaker treatment. The effect of treatment and the number of syncope, QTc, LVEF, incidence of cardiac events, frequency and duration of Td P seizures were compared between the two groups before and after treatment. Results: The total effective rate (82.6%) in the observation group was significantly higher than that in the control group (68.2%) (P <0.05). The number of syncope seizures, QTc, the number of cardiac events, the frequency of Td P seizures (P <0.05), and the duration of Td P episodes were significantly lower (P <0.05), and the observation group decreased more significantly (P <0.05), while there was no significant difference between the two groups (P> 0.05). Conclusion: β-blocker Betaloc combined with pacemaker implanted in LQTS complicated with Td P has significant curative effect, which is worthy of clinical application.