美托洛尔联合贝那普利对慢性充血性心力衰竭患者心功能及NT-proBNP水平的影响

Effect of betaloc combined with lotensin on cardiac function and NT-proBNP level in patients with chronic congestive heart failure

目的分析美托洛尔联合贝那普利对慢性充血性心力衰竭(CHF)患者心功能及血浆N-末端B型利钠肽原(NT-proBNP)水平的影响。方法选取2015年12月—2016年12月就诊于青海省人民医院的CHF患者210例,根据随机数表法将其分为3组,各70例。3组均予以常规检查及强心、利尿治疗,在此基础上,对照A组单纯加用贝那普利治疗,对照B组单纯加用美托洛尔治疗,观察组联合美托洛尔与贝那普利治疗。比较3组治疗前后心功能、运动耐力、NT-proBNP水平、血红蛋白(Hb)浓度、心率、血压、临床疗效及安全性。结果治疗前,3组心功能指标、运动耐力、NT-proBNP水平、Hb含量、心率、血压相比,差异无统计学意义;治疗后,3组以上指标均有改善,同治疗前比较差异有统计学意义(P<0.05);且观察组心功能、运动耐力明显优于对照A组、对照B组;观察组NT-proBNP水平、心率及血压均明显低于对照A组、对照B组;观察组Hb含量高于对照A组、对照组B组,差异均有统计学意义(P<0.05)。观察组总有效率为95.72%,明显高于对照A组的71.43%和对照B组的72.86%,差异均有统计学意义(P<0.05)。3组不良反应发生率相比,差异无统计学意义(P>0.05);结论美托洛尔联合贝那普利治疗CHF可有效改善患者心功能,缓解心衰,提高患者运动耐力,具有临床应用价值。

Objective To analyze the effect of betaloc combined with lotensin on cardiac function and N-terminal B type natriuretic peptide（NT-proBNP） level in patients with chronic congestive heart failure（CHF）. Methods 210 CHF patients in People‘s Hospital in Qinghai Province from December 2015 to December 2016 were divided into three groups by random number table, 70 cases in each. Three group were given routine examination, cardiotonic and diuretic treatment, and on this basis, control A group purely added lotensin, control B group purely added betaloc, observation goup took betaloc combined with lotensin. The cardiac function, exercise tolerance, NT-proBNP level, concentration of hemoglobin（Hb）, heart rate, blood pressure, clinical efficacy and safety before and after treatment were compared among the three groups. Results Before treatment, there was no statistical difference in the cardiac function, NT-proBNP level and Hb content among three groups; After treatment, the cardiac function and exercise tolerance of observation group were significantly better than those of control A and B group（P〈0.05） The NT-proBNP level, heart rate and blood pressure of observation group were significantly lower than those of control A and B group（P〈0.05） The Hb content of observation group was higher than that of control A and B group（P〈0.05）. The total effective rate of observation group was significantly higher than that of control A and B group（P〈0.05）. There was no statistical difference in the incidence of adverse reactions among three groups. Conclusion Betaloc combined with lotensin in treatment of CHF can effectively improve cardiac function, relieve heart failure and increase exercise tolerance of patients, which has clinical application value.