氯沙坦联合美托洛尔治疗老年人冠心病心力衰竭的疗效及对患者心功能、血浆脑钠肽和血液流变学指标的影响

The clinical effect of losartan combined with metoprolol tartrate in treatment of elderly patients with coro-nary heart failure and its effect on heart function, plasma brain natriuretic peptide and hemorheology

目的：探讨氯沙坦联合美托洛尔治疗老年人冠心病心力衰竭的疗效及其对心功能、血浆脑钠肽（ BNP）、血液流变学指标的影响。方法88例老年冠心病心力衰竭患者按随机数字表法分为两组各44例，均行冠心病心力衰竭的常规治疗，对照组在此基础上给予氯沙坦治疗，观察组在对照组基础上加用美托洛尔治疗，观察两组患者的临床疗效及对心功能、血浆脑钠肽和血液流变学指标的影响。结果观察组总有效率为95.45％，显著高于对照组的77．27％（χ2＝7．728，P＜0．05）；观察组各心功能指标和血浆BNP较对照组明显改善（ t＝6．55、6．02、7．41、13．24，均P＜0．05）；除血小板黏附率外，观察组治疗后各项血液流变学指标均较对照组明显改善（t＝7．84、7．32、6．55、7．02、5．89、5．70，均P＜0．05）。结论氯沙坦联合美托洛尔治疗老年人冠心病心力衰竭疗效显著，能有效改善患者的心功能、血浆脑钠肽水平及血液流变学指标，值得推广应用。

Objective To investigate the clinical effect of losartan combined with metoprolol tartrate in treat -ment of elderly patients with coronary heart failure and its effect on heart function ,plasma brain natriuretic peptide and hemorheology.Methods 88 elderly patients with coronary heart failure were randomly divided into two groups ,and 44 cases were in each group .All of the patients were given conventional treatment , and the control group was given losartan while the observation group was received metoprolol tartrate on the basis of the control group ,the clinical effi-cacy and effect on cardiac function ,plasma brain natriuretic peptide ,hemorheology indexes were compared between the two groups.Results The total effective rate of the observation group was 95.45% significantly higher than 77.27%of the control group （χ2 =7.728,P〈0.05）;cardiac function and plasma BNP were significant improvement compared with the control group（t=6.55,6.02,7.41 and 13.24,all P〈0.05）;after the treatment,except the plate-let adhesion rate ,the hemorheology of the observation group were significant improvement compared with the control group（t=7.84,7.32,6.55,7.02,5.89 and 5.70,all P〈0.05）.Conclusion Losartan combined with metoprolol tartrate in treatment of coronary heart failure is significant effect ,and it can effectively improve the patient′s cardiac function,plasma brain natriuretic peptide levels and blood rheology ,and it is worth to be applied in clinical .