内科

目的探讨曲美他嗪联合美托洛尔治疗心脏起搏器植入术后心房颤动患者的临床效果以及对C反应蛋白、白细胞介素-6水平的影响。方法选取2016年3月至2018年11月在我院行心脏起搏器植入术治疗的患者84例为研究对象，随机分为对照组与观察组，每组42例。两组患者均常规行心脏起搏器植入术治疗。术后90 d，对照组患者口服美托洛尔治疗，观察组患者口服美托洛尔+曲美他嗪治疗，连续治疗6个月。比较两组患者治疗6个月后的心房颤动负荷、起搏器模式转换次数以及心房颤动、无症状性心房颤动情况；比较两组患者治疗前后的炎症因子水平。结果治疗6个月后，观察组患者的心房颤动负荷低于对照组，起搏器模式转换次数少于对照组，差异有统计学意义（P＜0.05）；观察组患者的心房颤动发生率（9.52%）及无症状性心房颤动发生率（7.14%）均显著低于对照组（分别为28.57%和23.81%），差异有统计学意义（P＜0.05）。治疗前，两组患者的C反应蛋白、白细胞介素-6水平比较，差异无统计学意义（P＞0.05）；治疗6个月后，观察组患者的C反应蛋白、白细胞介素-6水平均显著低于对照组，差异有统计学意义（P＜0.05）。治疗期间，对照组患者不良反应发生率（11.90%）低于观察组（16.67%），但差异无统计学意义（P＞0.05）。结论曲美他嗪联合美托洛尔可有效降低心脏起搏器植入术治疗患者的心房颤动发生率及炎症因子表达水平，治疗安全性较高。

ObjectiveTo explore the clinical effect of trimetazidine combined with metoprolol on patients with atrial fibrillation after cardiac pacemaker implantation and its effect on C-reactive protein and interleukin-6 levels. MethodsA total of 84 patients undergoing cardiac pacemaker implantation in our hospital from March 2016 to November 2018 were selected as the research objects, and were randomly divided into control group and observation group, with 42 cases in each group. Patients in both groups routinely underwent pacemaker implantation. Ninety days after surgery, the control group orally administered metoprolol, and the observation group orally administered metoprolol + trimetazidine, for six-month continuous treatment. The atrial fibrillation load, pacemaker mode switching times, status of atrial fibrillation, and asymptomatic atrial fibrillation were compared between the two groups 6 months after treatment. The levels of inflammatory factors before and after treatment were compared between the two groups. ResultsAfter 6 months of treatment, compared to the control group, patients in the observation group obtained a lower load of atrial fibrillation, less pacemaker mode switching times, incidence of atrial fibrillation (9.52% vs. 28.57%), and asymptomatic atrial fibrillation (7.14% vs. 23.81%), in comparison with the control group, with statistically significant differences (P＜0.05). There were no statistically significant differences in the levels of C-reactive protein and interleukin-6 between the two groups before treatment (P＞0.05). After 6 months of treatment, the levels of C-reactive protein and interleukin-6 in the observation group were significantly lower than those in the control group, with statistically significant differences (P＜0.05). During treatment, the incidence of adverse reactions in the control group (11.90%) was lower than that in the observation group (16.67%), with no statistically significant difference (P＞0.05). ConclusionTrimetazidine combined with metoprolol can effectively decrease the incidence of atrial fibrillation and the expression levels of inflammatory factors in patients undergoing cardiac pacemaker implantation, with high safety of treatment.