美托洛尔治疗心脏瓣膜病伴心力衰竭对患者血压、心率、BNP、hs-CRP的影响

Effect of Metoprolol in Treatment of Valvular Heart Disease with Heart Failure on the Blood Pressure, Heart Rate, BNP, hs-CRP of Patients

目的探讨美托洛尔治疗心脏瓣膜病伴心力衰竭对患者血压、心率及B型利钠肽(BNP)、超敏C-反应蛋白(hs-CRP)水平的影响。方法以2016年4月—2017年3月间该院确诊为心脏瓣膜病伴心力衰竭患者70例,采用简单随机化法分为观察组(35例,给予常规治疗+酒石酸美托洛尔片口服治疗)和对照组(35例,给予常规治疗),治疗1个疗程后,观察两组患者收缩压(SBP)、舒张压(DBP)、心率及血清BNP、hs-CRP水平的变化,记录并比较不良反应发生情况。结果治疗后两组患者各项观察指标水平均明显降低,且观察组心率、血清BNP、血清hs-CRP水平均显著低于对照组,差异有统计学意义[心率:(72.03±4.58)次/min vs 83.48±5.70)次/min,t=9.26;血清BNP:(191.45±17.82)μg/L vs(274.61±18.76)μg/L,t=19.01;血清hs-CRP:(1.32±0.31)mg/L vs(1.84±0.34)mg/L,t=6.69;P<0.05);两组患者治疗期间总不良反应发生率比较(31.43%vs 45.71%),差异无统计学意义(χ~2=1.51,P>0.05)。结论美托洛尔辅以常规用药能够明显降低心脏瓣膜病伴心力衰竭患者血清BNP、hs-CRP水平,改善高血压症状及心率,且用药安全性高。

Objective To study the effect of metoprolol in treatment of valvular heart disease with heart failure on the blood pressure, heart rate, BNP, hs-CRP of patients. Methods 70 cases of patients with valvular heart disease with heart failure admitted and treated in our hospital Fromm April 2016 to March 2017, and randomly divided into two groups with 35 cases in each, the observation group used the routine therapy combined with oral administration of metoprolol tartrate tablets, while the control group used the routine therapy, after 1 treatment course, the SBP, DBP,heart rate and serum BNP and hs-CRP level of the two groups were observed. Results After treatment, various observation indexes of the two groups obviously decreased, and the heart rate, serum BNP and serum hs-CRP level were obviously lower than those in the control group, and the differences were statistically significant [heart rate：（72.03±4.58）times/min vs（83.48±5.70）times/min, t=9.26; serum BNP：（191.45±17.82）μg/L vs（274.61±18.76）μg/L,t=19.01; serum hs-CRP：（1.32±0.31）mg/L vs（1.84±0.34）mg/L, t=6.69; P〈0.05）, and the difference in the incidence rate of adverse reactions during the treatment between the two groups was not statistically significant（31.43% vs45.71%）（χ2=1.51, P〈0.05）. Conclusion The metoprolol combined with routine medication can obviously reduce the serum BNP and hs-CRP levels of patients with valvular heart disease with heart failure, and improve the hypertension and heart rate, and the medication safety is high.