美托洛尔联合阿托伐他汀钙治疗老年冠心病心绞痛患者的疗效及安全性观察

Efficacy and safety of metoprolol combined with atorvastatin calcium in the treatment of elderly patients with coronary heart disease and angina pectoris

目的探讨美托洛尔联合阿托伐他汀钙治疗老年冠心病心绞痛患者的临床效果。方法 180例老年冠心病心绞痛患者,参照分层抽样分组方式分为对照组和试验组,各90例。对照组患者给予阿托伐他汀钙治疗,试验组在对照组基础上给予美托洛尔治疗。比较两组患者治疗前后心绞痛发作次数和持续时长、血管内皮功能指标、血脂指标、治疗效果。结果治疗后,两组心绞痛发作次数少于治疗前,持续时长短于治疗前,且试验组心绞痛发作次数(2.31±0.43)次/周明显少于对照组的(6.02±0.75)次/周,持续时长(2.50±0.46)min/次明显短于对照组的(5.65±0.88)min/次,差异有统计学意义(P<0.05)。试验组总有效率为95.56%,明显高于对照组的81.11%,差异有统计学意义(P<0.05)。治疗后,两组血清内皮素(ET)和血管性假血友病因子(vWF)水平均明显低于治疗前,血管扩张变化率(FMD)水平明显高于治疗前,且试验组ET和vWF水平均明显低于对照组, FMD水平明显高于对照组,差异有统计学意义(P<0.05)。治疗后,两组总胆固醇(TC)、甘油三酯(TG)和低密度脂蛋白胆固醇(LDL-C)水平明显低于治疗前,高密度脂蛋白胆固醇(HDL-C)水平明显高于治疗前,且试验组TC、TG和LDL-C水平明显低于对照组, HDL-C水平明显高于对照组,差异有统计学意义(P<0.05)。结论针对老年冠心病心绞痛患者采用美托洛尔联合阿托伐他汀钙治疗,其可以显著减少心绞痛发作次数,缩短发作时长,改善血管内皮功能,提高患者临床治疗效果,值得推广运用。

Objective To discuss the clinical effect of metoprolol combined with atorvastatin calcium in the treatment of elderly patients with coronary heart disease and angina pectoris.Methods A total of 180 cases of elderly patients with coronary heart disease and angina pectoris were divided into control group and experimental group according to stratified sampling grouping method,with 90 cases in each group.The control group was treated with atorvastatin calcium,and the experimental group was treated with metoprolol on the basis of the control group.The frequency and duration of angina pectoris,vascular endothelial function index and blood lipid index before and after treatment and therapeutic effect of the two groups was compared.Results After treatment,the frequency of angina pectoris attacks in the two groups was less than those before treatment,and the duration was shorter than those before treatment.The frequency of angina pectoris attacks(2.31±0.43)times/week in the experimental group was significantly less than(6.02±0.75)times/week in the control group,and the duration(2.50±0.46)min/time was was significantly shorter than(5.65±0.88)min/time in the control group,and the difference was statistically significant(P<0.05).The total effective rate of the experimental group was 95.56%,which was obviously higher than 81.11%of the control group,and the difference was statistically significant(P<0.05).After treatment,the levels of serum endothelin(ET)and von Willebrand factor(vWF)in the two groups were significantly lower than those before treatment,and flow-mediated dilation(FMD)was significantly higher than those before treatment.The ET and vWF of the experimental group was obviously lower than those of the control group,and FMD was obviously higher than that of the control group,and the difference was statistically significant(P<0.05).After treatment,the total cholesterol(TC),triglyceride(TG)and low density lipoprotein cholesterol(LDL-C)of the two groups were obviously lower than those before treatment,and high density lipoprotein cholesterol(HDL-C)was obviously higher than those before treatment.The TC,TG and LDL-C of the experimental group was obviously lower than those of the control group,and HDL-C was obviously higher than that of the control group,and the difference was statistically significant(P<0.05).Conclusion For elderly patients with coronary heart disease and angina pectoris,metoprolol combined with atorvastatin calcium can significantly reduce the frequency of angina pectoris attacks,shorten duration of attacks,improve the vascular endothelial function and the clinical treatment effect of patients.It is worthy of popularization and application.