目的 研究心速寧膠囊聯(lián)合阿替洛爾治療老年冠心病室性早搏的臨床療效。方法 選取2023年5月—2024年10月南京市中心醫(yī)院收治的老年冠心病室性早搏患者120例，以隨機(jī)數(shù)字表法分為對照組和治療組，每組各60例。對照組口服阿替洛爾片，起始劑量為6.25 mg/次，2次/d，逐漸增加劑量至12.5 mg/次，每日最大劑量為50 mg。治療組在對照組基礎(chǔ)上口服心速寧膠囊，1.92 g/次，3次/d。兩組患者均治療4周。觀察兩組患者臨床療效，比較治療前后兩組患者室性早搏次數(shù)，室性早搏指數(shù)，心功能指標(biāo)左室射血分?jǐn)?shù)（LVEF）、每搏輸出量（SV）、左心室舒張末期容積（LVEDV）和左心室舒張末期內(nèi)徑（LVEDD），心率變異性指標(biāo)RR間期標(biāo)準(zhǔn)差（SDNN）、RR間期平均值標(biāo)準(zhǔn)差（SDANN）和相鄰RR間期差值均方根（RMSSD），血管內(nèi)皮功能指標(biāo)血栓素B₂（TXB₂）、內(nèi)皮素-1（ET-1）和一氧化氮（NO）。結(jié)果 治療后，治療組總有效率明顯高于對照組（91.67% vs 76.67%，P＜0.05）。治療后，兩組患者的室性早搏次數(shù)較治療前顯著減少，而室性早搏指數(shù)明顯升高（P＜0.05），且治療組室性早搏指標(biāo)明顯好于對照組（P＜0.05）。治療后，兩組患者心功能LVEF和SV顯著升高，而LVEDV和LVEDD顯著降低（P＜0.05），且治療組心功能指標(biāo)改善程度優(yōu)于對照組（P＜0.05）。治療后，兩組患者的心率變異性指標(biāo)較治療前均顯著升高（P＜0.05），且治療組SDNN、SDANN、RMSSD均高于對照組（P＜0.05）。治療后，兩組患者血管內(nèi)皮功能指標(biāo)較治療前顯著改善（P＜0.05），且治療組TXB₂、ET-1均低于對照組，而NO高于對照組（P＜0.05）。結(jié)論 心速寧膠囊聯(lián)合阿替洛爾片治療老年冠心病室性早搏臨床療效顯著，可降低室性早搏的發(fā)生次數(shù)，改善患者心功能指標(biāo)、心率變異性指標(biāo)和血管內(nèi)皮功能指標(biāo)。

Objective To investigate the clinical efficacy of Xinsuning Capsules combined with atenolol in treatment of ventricular premature contractions in elderly patients with coronary heart disease. Methods Patients (120 cases) with ventricular premature contractions of coronary heart disease in Nanjing Central Hospital from May 2023 to October 2024 were divided into control and treatment group according to random number table method, and each group had 60 cases. Patient in the control group were po administered with Atenolol Tablets, the starting dose was 6.25 mg/time, twice daily, and the dose was gradually increased to 12.5 mg/time with a maximum daily dose of 50 mg. Patient in the treatment group were po administered with Xinsuning Capsules on the basis of the control group, 1.92 g/time, three times daily. Patient in two groups were treated for 4 weeks. After treatment, the clinical evaluations were evaluated, and the frequency of premature ventricular beats, VPI, cardiac function indicators LVEF, SV, LVEDV and LVEDD, heart rate variability indicators SDNN, SDANN and RMSSD, endothelial function indicators TXB₂, ET-1 and NO in two groups before and after treatment were compared. Results After treatment, the total effective rate in the treatment group was significantly higher than that in the control group (91.67% vs 76.67%, P < 0.05). After treatment, the frequency of ventricular premature beats in patients in two groups was decreased significantly compared with before treatment, while the VPI increased significantly (P < 0.05), and the indexes of ventricular premature beats in the treatment group were significantly better than that in the control group (P < 0.05). After treatment, LVEF and SV of cardiac function in two groups were significantly increased, while LVEDV and LVEDD were significantly decreased (P < 0.05), and the improvement of cardiac function indicators in the treatment group was better than that in the control group (P < 0.05). After treatment, the heart rate variability indicators in two groups were significantly higher than those before treatment (P < 0.05), and SDNN, SDANN, and RMSSD in the treatment group were higher than those in the control group (P < 0.05). After treatment, the vascular endothelial function indicators in two groups were significantly improved compared with those before treatment (P < 0.05). TXB2 and ET-1 in the treatment group were lower than those in the control group, while NO was higher than that in the control group (P < 0.05). Conclusion The combination of Xinsuning Capsules and Atenolol Tablets has significant clinical efficacy in treating ventricular premature contractions in elderly patients with coronary heart disease. It can reduce the occurrence of premature ventricular contractions, improve patients' cardiac function indicators, heart rate variability indicators, and endothelial function indicators.

R972

南京市衛(wèi)生科技發(fā)展項(xiàng)目（YKK23198）