苯磺酸氨氯地平联合美托洛尔对高血压并心衰患者血清炎性因子及心功能的影响

Influence of amlodipine besylate combined metoprolol on serum inflammatory factor levels and cardiac function in aged patients with EH complicated CHF

目的:探讨苯磺酸氨氯地平片联合美托洛尔对老年原发性高血压(EH)合并慢性心力衰竭(CHF)患者血清炎性因子水平及心功能的影响。方法:选择2014年1月~2015年10月我院收治的老年EH合并CHF患者98例为研究对象。根据入院时间及单双号,患者被随机均分为美托洛尔组(在常规治疗基础上接受美托洛尔治疗)和联合治疗组(在美托洛尔组基础上接受苯磺酸氨氯地平片治疗),两组均治疗6个月。测量比较两组治疗前,治疗6个月后血清白介素(IL)-1、IL-6、肿瘤坏死因子-α(TNF-α)水平,左室舒张末内径(LVEDd)、左室收缩末内径(LVESd)和左室射血分数(LVEF),以及疗效。结果:与治疗前比较,治疗6个月后两组血清IL-1、IL-6、TNF-α水平、LVEDd和LVESd均显著降低,LVEF均显著升高(P均=0.001);且与美托洛尔组比较,联合治疗组治疗6个月后血清IL-1[(16.21±1.45)ng/L比(12.34±1.32)ng/L]、IL-6[(46.21±5.32)ng/L比(36.42±4.51)ng/L]、TNF-α[(23.12±2.14)ng/L比(19.25±2.41)ng/L]水平,LVEDd[(51.68±4.74)mm比(42.31±4.25)mm]和LVESd[(46.27±4.78)mm比(39.06±4.35)mm]降低更显著,LVEF[(43.26±4.37)%比(52.95±5.18)%]升高更显著,P均=0.001。联合治疗组总有效率显著高于美托洛尔组(93.88%比79.59%),P=0.037。两组不良反应发生率比较无显著差异,P=0.505。结论:苯磺酸氨氯地平片联合美托洛尔治疗老年原发性高血压合并心衰患者疗效显著,可降低患者血清炎性因子水平、减缓心室重塑、改善心功能。

Objective:To explore influence of amlodipine besylate tablet combined metoprolol on serum inflammatory factor levels and cardiac function in aged patients with essential hypertension(EH)complicated chronic heart failure(CHF).Methods:A total of 98 aged EH+CHF patients treated in our hospital from Jan 2014 to Oct 2015 were selected.Patients were randomly and equally divided into metoprolol group(received metoprolol based on routine treatment)and combined treatment group(received amlodipine besylate tablet based on metoprolol group),both groups were treated for six months.Serum levels of interleukin(IL)-1,IL-6 and tumor necrosis factor(TNF)-α,left ventricular end-diastolic dimension(LVEDd),left ventricular end-systolic dimension(LVESd)and left ventricular ejection fraction(LVEF)before and six months after treatment,and therapeutic effect were measured and compared between two groups.Results:Compared with before treatment,after six-month treatment,there were significant reductions in serum levels of IL-1,IL-6,TNF-α,LVEDd and LVESd,and significant rise in LVEF in two groups,P=0.001 all;compared with metoprolol group after six-month treatment,there were significant reductions in serum levels of IL-1[(16.21±1.45)ng/L vs.(12.34±1.32)ng/L],IL-6[(46.21±5.32)ng/L vs.(36.42±4.51)ng/L],TNF-α[(23.12±2.14)ng/L vs.(19.25±2.41)ng/L],LVEDd[(51.68±4.74)mm vs.(42.31±4.25)mm]and LVESd[(46.27±4.78)mm vs.(39.06±4.35)mm],and significant rise in LVEF[(43.26±4.37)%vs.(52.95±5.18)%]in combined treatment group,P=0.001 all.Total effective rate of combined treatment group was significantly higher than that of metoprolol group(93.88%vs.79.59%),P=0.037.There was no significant difference in incidence rate of adverse reactions between two groups,P=0.505.Conclusion:Amlodipine besylate combined metoprolol possesses significant therapeutic effect on aged EH+CHF patients,which may reduce serum inflammatory factor levels,relieve ventricular remodeling and improve cardiac function.