小剂量阿司匹林联合美托洛尔对老年慢性心力衰竭患者血液高凝和心功能的研究

Clinical study of low-dose aspirin combined with metoprolol on the blood coagulation and cardiac function of the elderly patients with chronic heart failure

目的探究小剂量阿司匹林联合美托洛尔治疗老年慢性心衰的临床疗效。方法选取2011年7月—2013年7月总后勤部广州离职干部休养所门诊部就诊的老年慢性心衰患者84例,依据分层随机分组方法将患者分为治疗组与对照组,每组42例,治疗组口服小剂量阿司匹林肠溶片,75 mg/次,1次/d;同时,口服酒石酸美托洛尔6.25 mg/次,2次/d,配合常规抗心衰治疗。对照组仅予以常规抗心衰治疗,两组均治疗4周。观察两组患者治疗前后血浆P-选择素、血管性假性血友病因子、D-二聚体水平、脑利钠肽水平及心功能改善情况。结果治疗4周后,两组患者血浆P-选择素、血管性假性血友病因子和D-二聚体水平均较治疗前有所下降,治疗前后差异均有统计学意义(P<0.05);治疗后治疗组患者的血浆P-选择素、血管性假性血友病因子和D-二聚体水平均低于对照组,两组差异有统计学意义(P<0.05)。治疗1、2、3、4周后,两组患者脑利钠肽水平均较治疗前有所下降,治疗前后差异均有统计学意义(P<0.05)。治疗后,治疗组患者的脑利钠肽水平均低于同期对照组患者,两组差异有统计学意义(P<0.05)。治疗后,治疗组和对照组的总有效率分别为85.71%、57.14%,两组比较差异有统计学意义(P<0.05)。结论小剂量阿司匹林联合美托洛尔配合标准抗心衰治疗对于老年慢性心衰患者具有较好的抗血栓形成和促进患者心功能恢复的作用,建议临床推广使用。

Objective To explore the clinical efficacy of low-dose aspirin combined with metoprolol on elderly patients with chronic heart failure. Methods Eighty-four cases of elderly patients with chronic heart failure who came to Clinic Department of Resthome for Retired Veterans in Guangzhou from July 2011 to July 2013 for treatment were selected as the sample. The patients were divided into treatment group and control group according to stratified randomization method, and there are 42 cases in each group. The treatment group was po administered with low-dose aspirin enteric-coated metformin hydrochloride, once 75 mg, once daily, and combined with Metoprolol Tablets, once 6.25 mg, twice daily, along with conventional therapy, while the patients in the control group were given conventional therapy only. Both groups were treated for 4 weeks. The plasma P-selectin, yon Willebrand factor, D-dimer, brain natriuretic peptide, and cardiac function improvement of the two groups were compared before and 4 weeks after the therapy.Results After the treatment, plasma P-selectin, von Willebrand factor, and D-dimer were decreased, and there were significant differences before and after the treatment （P〈0.05）. After the treatment, plasma P-selectin, yon Willebrand factor, and D-dimer of the patients in the treatment group were lower than those of the patients in the control group, and the differences between the two groups had statistical significance （P〈0.05）. Within 1 --4 weeks after the treatment, brain natriuretic peptide of the patients in the two groups was decreased, and the differences before and after the treatment were statistically significant （P〈0.05）. After the treatment, the brain natriuretic peptide of the patients in the treatment group was lower than that of the patients in the dontrol group during the same period, and the differences between the two groups were statistically significant （P〈0.05）. After the treatment, the total effective rates in the treatment and control groups were 85.71% and 57.14%. And there were significant differences between the two groups （P〈0.05）. Conclusion Low-dose aspirin combined with metoprolol along with conventional therapy can be better at antithrombotic and promoting the recovery of cardiac fimction, which is worth clinical development and application.