美托洛尔联合曲美他嗪治疗冠心病心力衰竭的疗效观察及对患者血清炎性因子的影响

Effect of metoprolol combined with trimetazidine on heart failure patients with coronary heart disease and its effect on inflammatory factors

目的观察美托洛尔联合曲美他嗪治疗冠心病心力衰竭的疗效及对患者血清炎性因子的影响。方法选择余姚市人民医院2018年7月至2019年7月收治的冠心病心力衰竭患者182例,按照随机数字表法分为观察组91例与对照组91例。对照组患者给予曲美他嗪治疗,观察组在对照组基础上联合美托洛尔治疗。两组疗程均为3个月。比较两组治疗疗效,治疗前后心功能、炎性因子、血浆B型尿钠肽(BNP)和6 min步行距离(6WMT)变化。结果观察组总有效率(91.21%)高于对照组(76.92%)(χ^2=6.933,P<0.05);观察组治疗后左室收缩末期内径(LVESD)[(45.78±4.35)mm和左室舒张末期内径(LVEDD)[(38.29±3.24)mm]低于对照组的(51.20±3.01)mm和(43.10±2.65)mm,而左室射血分数(LVEF)[(49.83±3.86)%]高于对照组的(43.25±2.69)%(t=9.774、10.962、13.341,均P<0.05);观察组治疗后血清肿瘤坏死因子α(TNF-α)[(4.35±1.30)mg/L]和超敏C反应蛋白(hs-CRP)[(2.63±0.54)mg/L]均低于对照组的(7.84±2.38)mg/L和(3.98±0.76)mg/L(t=12.276、13.813,均P<0.05);观察组治疗后血浆BNP[(317.94±24.35)pg/mL]低于对照组的(384.35±18.97)pg/mL,而6WMT[(341.32±35.41)m]高于对照组[(289.78±25.45)m](t=20.524、11.275,均P<0.05)。结论美托洛尔联合曲美他嗪治疗冠心病心力衰竭患者疗效明显,且可明显改善患者心功能,减轻炎性反应。

Objective To investigate the therapeutic effect of metoprolol combined with trimetazidine on patients with coronary heart disease and heart failure and its effect on inflammatory factors.Methods From July 2018 to July 2019,182 patients with coronary heart disease and heart failure admitted to Yuyao People's Hospital were selected,and they were divided into observation group(91 cases)and control group(91 cases)according to the random digital table method.The control group was treated with trimetazidine,while the observation group was treated with metoprolol on the basis of the control group.The course of treatment in both two groups was 3 months.The changes of cardiac function,inflammatory factors,plasma B-type natriuretic peptide(BNP)and 6-minute walking distance(6 WMT)were compared before and after treatment.Results The total effective rate of the observation group(91.21%)was higher than that of the control group(76.92%)(χ^2=6.933,P<0.05).After treatment,the LVEDD[(45.78±4.35)mm]and LVESD[(38.29±3.24)mm]in the observation group were lower than those in the control group[(51.20±3.01)mm and(43.10±2.65)mm],while the LVEF[(49.83±3.86)%]was higher than that in the control group[(43.25±2.69)%],the differences were statistically significant(t=9.774,10.962,13.341,all P<0.05).The serum TNF-α[(4.35±1.30)mg/L]and hs-CRP[(2.63±0.54)mg/L]in the observation group were lower than those in the control group[(7.84±2.38)mg/L and(3.98±0.76)mg/L](t=12.276,13.813,all P<0.05).After treatment,the BNP[(317.94±24.35)pg/mL]in the observation group was lower than that in the control group[(384.35±18.97)pg/mL],while the 6WMT[(341.32±35.41)m]was higher than that in the control group[(289.78±25.45)m],the differences were statistically significant(t=20.524,11.275,all P<0.05).Conclusion Metoprolol combined with trimetazidine has obvious curative effect on patients with coronary heart disease and heart failure,and it can improve the heart function,reduce the inflammatory reaction.