美托洛尔联合曲美他嗪治疗冠心病心力衰竭的效果观察

Effects of metoprolol combined with trimetazidine in the treatment of coronary heart disease with heart failure

目的探讨美托洛尔联合曲美他嗪治疗冠状动脉性心脏病(以下简称冠心病)心力衰竭患者的临床效果。方法选取2016年10月至2018年10月威海市立第三医院收治的106例冠心病心力衰竭患者作为研究对象,采用随机数字表法将其分为观察组与对照组,每组53例。对照组给予β受体阻滞剂、血管紧张素转换酶抑制剂、强心剂与利尿剂等常规治疗,β受体阻滞剂选用美托洛尔;观察组在对照组基础上再给予曲美他嗪治疗。比较两组患者的治疗效果与不良反应发生情况。结果①观察组治疗后总有效率(98.11%)高于对照组(84.91%),差异有统计学意义(P<0.05);②观察组治疗后心功能指标左室射血分数(LVEF)、左室收缩末期内径、左室舒张末期内径水平均优于对照组(P均<0.05);③观察组超敏C反应蛋白、肿瘤坏死因子-α、白细胞介素-6水平均优于对照组(P均<0.05);④两组治疗期间均未见严重不良反应,两组轻微不良反应发生率均较低(观察组5.67%,对照组3.77%),两组不良反应发生率比较差异未见统计学意义(P>0.05)。结论冠心病心力衰竭患者接受美托洛尔与曲美他嗪联合治疗能有效改善患者的心功能,调节体内炎性因子水平,其安全性较高,值得临床推广。

Objective To investigate the effects of metoprolol combined with trimetazidine on patients with coronary heart disease and heart failure.Methods A total of 106 patients with coronary heart disease and heart failure treated in Weihai Municipal Third Hospital from October 2016 to October 2018 were selected as the study subjects.All the patients were divided into observation group and control group by random number table method,with 53 cases in each group.The control group was given conventional treatment+metoprolol.The observation group was given trimetazidine.The therapeutic effects and adverse reactions of the two groups were compared.Results①The total effective rate of observation group(98.11%)was higher than that of the control group(84.91%),and the difference was statistically significant(P<0.05).②The left ventricular ejection fraction(LVEF),left ventricular end-systolic diameter(LVESD),left ventricular end-diastolic diameter(LVEDD)levels in the observation group were better than those in the control group(P<0.05).③The levels of high-sensitivity C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α),and interleukin-6(IL-6)in the observation group were better than those in the control group(P<0.05).④There were no serious adverse reactions during the treatment period.The incidence of mild adverse reactions was lower in both groups(5.67%in the observation group and 3.77%in the control group).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions The combination of metoprolol and trimetazidine in the treatment of patients with coronary heart disease and heart failure can effectively improve the heart function of patients and regulate the high expression of inflammatory factors in the body,with high safety.