美托洛爾聯(lián)合曲美他嗪治療冠心病心力衰竭患者的臨床效果

孫立平　趙曉峰

[摘要]目的 探討美托洛爾聯(lián)合曲美他嗪治療冠心病心力衰竭患者的臨床效果。方法 選取2017年6月～2018年6月我院收治的110例冠心病心力衰竭患者作為研究對(duì)象，按照入院日期單雙號(hào)分為實(shí)驗(yàn)組（n=55）和對(duì)照組（n=55）。對(duì)照組給予常規(guī)治療，實(shí)驗(yàn)組給予美托洛爾聯(lián)合曲美他嗪治療。比較兩組的治療效果、心功能指標(biāo)、C反應(yīng)蛋白（CRP）、腫瘤壞死因子-ɑ（TNF-ɑ）、白介素-6（IL-6）、白介素-12（IL-12）等炎性因子水平及治療前后的血清腦鈉肽（BNP）水平。結(jié)果 實(shí)驗(yàn)組的治療總有效率高于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）;實(shí)驗(yàn)組的CRP、TNF-ɑ、IL-6、IL-12水平低于對(duì)照組，差異均有統(tǒng)計(jì)學(xué)意義（P<0.05）;實(shí)驗(yàn)組患者的射血分?jǐn)?shù)（LVEF）水平高于對(duì)照組，左心室舒張末期內(nèi)徑（LVEDD）和左心室收縮末期內(nèi)徑（LVESD）水平低于對(duì)照組，差異均有統(tǒng)計(jì)學(xué)意義（P<0.05）;實(shí)驗(yàn)組治療后的BNP水平低于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 冠心病心力衰竭患者應(yīng)用美托洛爾聯(lián)合曲美他嗪治療的效果顯著，可改善患者的心功能，降低炎性因子的水平，值得臨床推廣應(yīng)用。

[關(guān)鍵詞]美托洛爾;曲美他嗪;冠心病;心力衰竭;臨床效果

[中圖分類號(hào)] R541.4? ? ? ? ? [文獻(xiàn)標(biāo)識(shí)碼] A? ? ? ? ? [文章編號(hào)] 1674-4721（2019）10（a）-0054-03

[Abstract] Objective To explore the clinical effect of Metoprolol combined with Trimetazidine in the treatment of coronary heart disease and heart failure. Methods A total of 110 patients with coronary heart disease and heart failure admitted to our hospital from June 2017 to June 2018 were selected as the study subjects， they were divided into experimental group （n=55） and control group （n=55） according to the date of admission. The control group was given routine treatment， while the experimental group was given Metoprolol combined with Trimetazidine. The therapeutic effect， cardiac function index， C-reactive protein （CRP）， tumor necrosis factor-α （TNF-α）， interleukin-6 （IL-6）， interleukin-12 （IL-12） and serum brain natriuretic peptide （BNP） levels before and after treatment were compared between the two groups. Results The total effective rate of the experimental group was higher than that of the control group， the difference was statistically significant （P<0.05）. The levels of CRP， TNF-α， IL-6 and IL-12 in the experimental group were lower than those in the control group， the differences were statistically significant （P<0.05）. The level of ejection fraction （LVEF） in the experimental group was higher than that in the control group， the levels of left ventricular end-diastolic diameter （LVEDD） and left ventricular end-systolic diameter （LVESD） were lower than those in the control group， the differences were statistically significant （P<0.05）. The level of BNP in the experimental group was lower than that in the control group， the difference was statistically significant （P<0.05）. Conclusion The effect of Metoprolol combined with Trimetazidine in the treatment of coronary heart disease patients with heart failure is remarkable. It can improve the cardiac function of patients and reduce the level of inflammatory factors. It is worthy of clinical application.

綜上所述，冠心病心力衰竭患者應(yīng)用美托洛爾聯(lián)合曲美他嗪治療的效果顯著，可改善患者的心功能，降低炎性因子的水平，值得臨床推廣應(yīng)用。但本研究選取樣本數(shù)量較少，研究時(shí)間較短，對(duì)于聯(lián)合治療后出現(xiàn)的不良反應(yīng)尚未進(jìn)行研究，因此在后期研究中，需擴(kuò)大研究的樣本量，延長(zhǎng)研究時(shí)間，提高研究?jī)r(jià)值，為疾病的臨床治療提供參考。

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（收稿日期：2019-03-20? 本文編輯：劉克明）