曲美他嗪联合美托洛尔治疗老年冠心病心力衰竭的疗效及对患者心功能、心肌重构和炎性因子的影响

The efficacy of trimetazidine combined with metoprolol in the treatment of heart failure in elderly patients with coronary heart disease and its effects on cardiac function,myocardial remodeling and inflammatory factors

目的观察曲美他嗪联合美托洛尔治疗老年冠心病心力衰竭的疗效及对患者心功能、心肌重构和炎性因子的影响。方法选取2017年6月-2019年6月广东省惠州市第三人民医院老年病科收治的老年冠心病心力衰竭患者120例,按照患者入院顺序单双数随机分为观察组和对照组各60例。2组均给予常规治疗,对照组在常规治疗基础上给予美托洛尔治疗,观察组在对照组治疗的基础上给予曲美他嗪治疗。比较2组患者的临床疗效、治疗前后心功能[左室射血分数(LVEF)、6 min步行距离(6MWT)]、心肌重构情况[左室舒张末期直径(LVEDd)、左室收缩末期直径(LVESd)]及炎性因子[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)]水平。结果观察组患者总有效率为95.00%,高于对照组的83.33%(χ~2=4.227,P<0.05);治疗后,2组患者LVEF及6MWT均优于治疗前(P<0.05或P<0.01),且观察组优于对照组(P<0.01);治疗后,2组患者LVEDd、LVESd、IL-6、TNF-α及hs-CRP水平均低于治疗前(P<0.05),且观察组低于对照组(P<0.05)。结论曲美他嗪联合美托洛尔治疗老年冠心病心力衰竭可改善患者的心功能,降低炎性因子水平。

Objective To observe the curative effect of trimetazidine combined with metoprolol in the treatment of heart failure in elderly patients with coronary heart disease and its effect on patients’cardiac function,myocardial remodeling and inflammatory factors.Methods 120 elderly patients of coronary heart disease with heart failure admitted to the Department of Geriatrics,the Third People’s Hospital of Huizhou,Guangdong Province from June 2017 to June 2019 were selected,according to the order of admission,they were randomly divided into observation group and control group,60 cases in each group.Both groups were given conventional treatment,the control group was given metoprolol treatment based on conventional treatment,and the observation group was given trimetazidine treatment based on control group treatment.The clinical efficacy,cardiac function(LVEF,6 MWT)before and after treatment,myocardial remodeling(LVEDd,LVESd)and the levels of inflammatory factor(IL-6,TNF-α,hs-CRP)were compared between the two groups.Results The total effective rate of patients in the observation group(95.00%)was higher than that in the control group(83.33%)(χ~2=4.227,P<0.05);after treatment,the LVEF and 6 MWT of the two groups were better than before treatment(P<0.05 or P<0.01),and the observation group was better than the control group(P<0.01);the levels of LVEDd,LVESd,IL-6,TNF-αand hs-CRP in the two groups were lower than before treatment(P<0.05),and the observation group was lower than the control group(P<0.05).Conclusion Trimetazidine combined with metoprolol in elderly patients with coronary heart disease and heart failure can improve the heart function of patients and reduce the level of inflammatory factors.