美托洛尔联合曲美他嗪治疗冠心病心力衰竭患者的临床效果

孙立平　赵晓峰

[摘要]目的 探讨美托洛尔联合曲美他嗪治疗冠心病心力衰竭患者的临床效果。方法 选取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为研究对象，按照入院日期单双号分为实验组（n=55）和对照组（n=55）。对照组给予常规治疗，实验组给予美托洛尔联合曲美他嗪治疗。比较两组的治疗效果、心功能指标、C反应蛋白（CRP）、肿瘤坏死因子-ɑ（TNF-ɑ）、白介素-6（IL-6）、白介素-12（IL-12）等炎性因子水平及治疗前后的血清脑钠肽（BNP）水平。结果 实验组的治疗总有效率高于对照组，差异有统计学意义（P<0.05）;实验组的CRP、TNF-ɑ、IL-6、IL-12水平低于对照组，差异均有统计学意义（P<0.05）;实验组患者的射血分数（LVEF）水平高于对照组，左心室舒张末期内径（LVEDD）和左心室收缩末期内径（LVESD）水平低于对照组，差异均有统计学意义（P<0.05）;实验组治疗后的BNP水平低于对照组，差异有统计学意义（P<0.05）。结论 冠心病心力衰竭患者应用美托洛尔联合曲美他嗪治疗的效果显著，可改善患者的心功能，降低炎性因子的水平，值得临床推广应用。

[关键词]美托洛爾;曲美他嗪;冠心病;心力衰竭;临床效果

[中图分类号] R541.4          [文献标识码] A          [文章编号] 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.

综上所述，冠心病心力衰竭患者应用美托洛尔联合曲美他嗪治疗的效果显著，可改善患者的心功能，降低炎性因子的水平，值得临床推广应用。但本研究选取样本数量较少，研究时间较短，对于联合治疗后出现的不良反应尚未进行研究，因此在后期研究中，需扩大研究的样本量，延长研究时间，提高研究价值，为疾病的临床治疗提供参考。

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（收稿日期：2019-03-20  本文编辑：刘克明）