摘要目的:观察胺碘酮联合美托洛尔治疗急性心肌梗死合并心律失常患者的临床效果。方法:抽取2019年2月至2020年6月在新乡市中心医院治疗的78例急性心肌梗死合并心律失常患者为研究对象，采取随机数字表法将其分为两组。对照组39例单用胺碘酮治疗，观察组39例在对照组治疗基础上使用美托洛尔联合治疗。比较两组患者的临床疗效、心脏功能指标、心肌损伤指标及用药安全性。结果:观察组总有效率(94.87%，37/39)高于对照组(79.49%，31/39)，差异有统计学意义( P<0.05)。两组不良反应发生率比较差异未见统计学意义( P>0.05)。治疗后，观察组左室舒张末期内径小于对照组，左室射血分数、心输出量水平高于对照组( P<0.05)，肌酸激酶同工酶、N末端脑钠肽前体水平低于对照组( P<0.05)。 结论:对急性心肌梗死合并心律失常患者采用胺碘酮联合美托洛尔治疗，可改善患者心脏功能，减轻心肌损伤，且安全性良好。

abstractsObjective:To analyze the effects of amiodarone combined with metoprolol on patients with acute myocardial infarction complicated by arrhythmia.Methods:A total of 78 patients with acute myocardial infarction complicated by arrhythmia who were treated in Xinxiang Central Hospital from February 2019 to June 2020 were selected and divided into two groups by random number table method. The 39 patients in the control group were treated with amiodarone alone; and 39 patients in the observation group were treated with metoprolol based on the treatment of control group. The clinical efficacy, cardiac function indexes, myocardial injury indexes, and medication safety of the two groups were compared.Results:The total effective rate of the observation group (94.87%, 37/39) was significantly higher than the of the control group (79.49%, 31/39), P<0.05. There was no significant difference in adverse reaction rate between the two groups ( P>0.05). After treatment, the left ventricular end-diastolic diameter of the observation group was significantly lower than that of the control group, while the levels of left ventricular ejection fraction, cardiac output were higher than those of the control group ( P<0.05). The levels of creatine kinase isoenzymes and N-terminal pro-brain nitric peptide of the observation group were significantly lower than those of the control group ( P<0.05). Conclusions:The combination of amiodarone and metoprolol, in the treatment of acute myocardial infarction complicated by arrhythmia, can increase the therapeutic effect, improve the cardiac function, and reduce myocardial damage, with good safety.