美托洛尔联合螺内酯对慢性心衰患者血流动力学及心肌重构的影响

Effects of Metoprolol Combined with Spironolactone on Hemodynamics and Myocardial Remodeling in Patients with Chronic Heart Failure

目的探讨美托洛尔联合螺内酯对慢性心衰患者血流动力学及心肌重构的影响.方法选择2021年4月—2022年5月我院收治的116例慢性心衰患者为研究对象,按随机数字表法分为两组,每组58例.对照组口服螺内酯,观察组口服美托洛尔及螺内酯,两组均持续用药6个月.对比两组患者的临床疗效、血流动力学、心肌重构指标及不良反应发生情况.结果观察组的治疗总有效率为94.83%,高于对照组的81.04%,差异有统计学意义(P<0.05).观察组治疗后的收缩压、心率分别为(93.64±9.34)mmHg、(94.87±8.64)次/min,均低于对照组的(113.46±11.24)mmHg、(115.64±10.32)次/min,舒张压、射血分数分别为(73.49±8.36)mmHg、(48.79±5.58)%,均高于对照组的(62.61±7.96)mmHg、(37.54±4.65)%,组间差异有统计学意义(P<0.05).观察组治疗后的左心室收缩末期内径、左心室舒张末期内径分别为(35.13±2.87)mm、(50.48±2.89)mm,均短于对照组的(38.26±3.25)mm、(54.36±3.29)mm,左心室收缩末期容积、左心室舒张末期容积分别为(51.28±6.44)mL、(92.64±7.41)mL,均小于对照组的(55.14±7.13)mL,(98.52±8.64)mL,组间差异有统计学意义(P<0.05).两组的不良反应发生率比较,差异无统计学意义(P>0.05).结论美托洛尔联合螺内酯能提高慢性心衰的临床疗效,明显改善患者的血流动力学与心肌重构指标,且安全性较高.

Objective To explore the effect of metoprolol combined with spironolactone on hemodynamics and myocardial remodeling in patients with chronic heart failure.Methods 116 patients with chronic heart failure admitted to the hospital from April 2021 to May 2022 were selected as the research objects and were divided into two groups by random number table method,with 58 cases in each group.The control group took spironolactone orally,the observation group took metoprolol and spironolactone orally.Both groups were given continuous medication for 6 months.The clinical efficacy,hemodynamics,myocardial remodeling indexes and the occurrence of adverse reactions were compared between the two groups.Results The total effective rate of the observation group was 94.83%,higher than 81.04%of the control group,the difference was statistically significant(P<0.05).The systolic blood pressure and heart rate of the observation group after treatment were(93.64±9.34)mmHg and(94.87±8.64)times/min,respectively,lower than(113.46±11.24)mmHg and(115.64±10.32)times/min of the control group,the diastolic blood pressure and ejection fraction were(73.49±8.36)mmHg and(48.79±5.58)%,respectively,higher than(62.61±7.96)mmHg and(37.54±4.65)%in the control group,and the differences between the groups were statistically significant(P<0.05).The left ventricular end-systolic internal diameter and left ventricular enddiastolic internal diameter of the observation group after treatment were(35.13±2.87)mm and(50.48±2.89)mm,respectively,which were shorter than those of the control group(38.26±3.25)mm and(54.36±3.29)mm,and the left ventricular end-systolic volume and left ventricular end-diastolic volume were(51.28±6.44)mL,(92.64±7.41)mL,which were less than(55.14±7.13)mL,(98.52±8.64)mL in the control group,in the control group,and the differences between the groups were statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Metoprolol combined with spironolactone can improve the clinical efficacy,hemodynamics and myocardial remodeling indexes of patients with chronic heart failure,and has high safety.