辅酶Q10片联合美托洛尔治疗慢性心力衰竭的临床研究

Clinical study on Coenzyme Q10 Tablets combined with metoprolol in treatment of chronic heart failure

目的探讨辅酶Q10片联合美托洛尔片治疗慢性心力衰竭的临床疗效。方法收集2015年9月—2016年9月在南阳市中心医院进行治疗的慢性心力衰竭患者86例,随机分为对照组和治疗组,每组各43例。对照组患者口服酒石酸美托洛尔片,初始剂量6.25 mg/次,2次/d,可耐受情况下,每隔1周增加6.25 mg,8周内增加至50 mg/d,2次/d。治疗组在对照组的基础上口服辅酶Q10片,1片/次,3次/d。两组患者均连续治疗12周。评价两组临床疗效,同时比较两组治疗前后心功能指标和血清细胞因子水平。结果治疗后,对照组的总有效率为72.09%,显著低于治疗组的90.70%,两组比较差异有统计学意义(P<0.05)。治疗后,两组患者NYHA分级、左心室舒张末期内径(LVEDD)和左心室收缩期末内径(LVESD)均比同组治疗前明显降低,左心室射血分数(LVEE)则显著升高,同组比较差异具有统计学意义(P<0.05);且治疗组心功能指标优于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者血清白细胞介素-6(IL-6)、IL-12、肿瘤坏死因子-α(TNF-α)、脑钠肽(BNP)水平均低于治疗前,同组比较差异具有统计学意义(P<0.05);且治疗后治疗组患者降低水平优于对照组,两组比较差异具有统计学意义(P<0.05)。结论辅酶Q10联合美托洛尔治疗慢性心力衰竭效果显著,可明显改善患者左心室功能,并降低机体炎症反应,具有一定的临床推广应用价值。

Objective To investigate the clinical efficacy of Coenzyme Q10 Tablets combined with metoprolol in treatment of chronic heart failure.Methods Patients （43 cases） with chronic heart failure in Nanyang City Central Hospital from September 2015 to September 2016 were randomly divided into control and treatment groups, and each group had 43 cases. Patients in the control group werepoadministered with Metoprolol Tartrate Tablets, the first dosage was 6.25 mg/time, twice daily, which was increased by 6.25 mg per week based on tolerable condition and to 50 mg/d within eight weeks, twice daily. Patients in the treatment group were po administered with Coenzyme Q10 Tablets on the basis of the control group, 1 tablet/time, once daily. Patients in two groups were treated for 12 weeks. After treatment, the clinical efficacy was evaluated, and the cardiac function indexes, serum cytokines in two groups were compared.Results After treatment, the clinical efficacy in the control group was 72.09%, which was significantly lower than 90.70% in the treatment group, with significant difference between two groups （P 〈 0.05）. After treatment, the NYHA grade, LVEDD, and VESD in two groupssignificantly decreased, LVEE significantly increased, and the difference was statistically significant in the same group （P 〈 0.05）. And these cardiac function indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups （P 〈 0.05）. After treatment, the IL-6, IL-12, TNF-α, and BNP levels in two groups significantly decreased, and there was difference in the same groups （P 〈 0.05）. And these levels in the treatment group were significantly better than those in the control group, with significant difference between two groups （P 〈 0.05）.Conclusion Coenzyme Q10 Tablets combined with metoprolol has remarkable effect in treatment of chronic heart failure, can significantly improve left ventricular function, and reduce the inflammatory response, which has a certain clinical application value.