阿托伐他汀钙片联合酒石酸美托洛尔片治疗冠心病心力衰竭的临床疗效及对血浆氨基末端B型脑利钠肽前体水平的影响

Clinical Effect of Atorvastatin Calcium Tablets Combined with Metoprolol Tartrate Tablets on Coronary Heart Disease-induced Heart Failure and the Impact on Plasma NT-proBNP Level

目的分析阿托伐他汀钙片联合酒石酸美托洛尔片治疗冠心病心力衰竭的临床疗效及对血浆氨基末端B型脑利钠肽前体(NT-pro BNP)水平的影响。方法选取2013年1月—2015年6月宿迁市泗洪县人民医院心内科收治的冠心病心力衰竭患者98例,按随机数字表法分为对照组与观察组,每组49例。对照组患者予以常规治疗,观察组患者在对照组基础上予以阿托伐他汀钙片联合酒石酸美托洛尔片治疗;两组患者均连续治疗3个月。比较两组患者治疗前后血压〔收缩压(SBP)、舒张压(DBP)〕、心率(HR)、血浆NT-pro BNP水平、心功能指标〔左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、左心室射血分数(LVEF)〕、血脂指标〔总胆固醇(TC)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、载脂蛋白A(Apo A)、三酰甘油(TG)〕,不良反应发生情况。结果治疗前两组患者SBP、DBP、HR比较,差异无统计学意义(P>0.05);治疗后观察组患者SBP、DBP、HR低于对照组(P<0.05)。治疗前两组患者血浆NT-pro BNP水平比较,差异无统计学意义(P>0.05);治疗后观察组患者血浆NT-pro BNP水平低于对照组(P<0.05)。治疗前两组患者LVEDD、LVESD、LVEF比较,差异无统计学意义(P>0.05);治疗后观察组患者LVEDD、LVESD小于对照组,LVEF高于对照组(P<0.05)。治疗前两组患者TC、HDL、LDL、Apo A、TG水平比较,差异无统计学意义(P>0.05);治疗后观察组患者TC、LDL、TG水平低于对照组,HDL、Apo A水平高于对照组(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论阿托伐他汀钙片联合酒石酸美托洛尔片治疗冠心病心力衰竭的临床疗效确切,可有效降低患者血浆NT-pro BNP水平,改善患者心功能。

Objective To analyze the clinical effect of atorvastatin calcium tablets combined with metoprolol tartrate tablets on coronary heart disease-induced heart failure and the impact on plasma NT-pro BNP level. Methods From January2013 to June 2015,a total of 98 patients with coronary heart disease-induced heart failure were selected in the Department of Cardiology,the People’s Hospital of Sihong County,Suqian,and they were divided into control group and observation group according to random number table,each of 49 cases. Patients of control group received conventional treatment,while patients of observation group received atorvastatin calcium tablets combined with metoprolol tartrate tablets based on conventional treatment;both groups continuously treated for 3 months. SBP,DBP,HR,plasma NT-pro BNP level,index of cardiac function( including LVEDD,LVESD and LVEF),blood liquids index( including TC,HDL,LDL,Apo A and TG) before and after treatment,and incidence of adverse reactions were compared between the two groups. Results No statistically significant differences of SBP,DBP or HR was found between the two groups before treatment( P > 0. 05),while SBP,DBP and HR of observation group were statistically significantly lower than those of control group after treatment( P < 0. 05). No statistically significant differences of plasma NT-pro BNP level was found between the two groups before treatment( P > 0. 05),while plasma NT-pro BNP level of observation group was statistically significantly lower than that of control group after treatment( P < 0. 05). No statistically significant differences of LVEDD,LVESD or LVEF was found between the two groups before treatment( P > 0. 05);after treatment,LVEDD and LVESD of observation group were statistically significantly smaller than those of control group,while LVEF of observation group was statistically significantly higher than that of control group( P < 0. 05). No statistically significant differences of TC,HDL,LDL,Apo A or TG was found between the two groups before treatment( P > 0. 05);after treatment,TC,LDL and TG of observation group were statistically significantly lower than those of control group,while HDL and Apo A of observation group were statistically significantly higher than those of control group( P < 0. 05). No statistically significant differences of incidence of adverse reactions was found between the two groups( P > 0. 05). Conclusion Atorvastatin calcium tablets combined with metoprolol tartrate tablets has certain clinical effect in treating coronary heart disease-induced heart failure,can effectively reduce the plasma NT-pro BNP level and improve the cardiac function.