慢性心力衰竭患者应用美托洛尔联合依那普利治疗的效果探讨

An exploration of the efficacy of metoprolol combined with enalapril in treating the patients with chronic heart failure

目的探讨慢性心力衰竭(CHF)患者应用美托洛尔联合依那普利治疗的效果。方法应用随机数字表法将2019年4~12月贵州省遵义市播州区人民医院心内科收治的91例CHF患者分为两组,对照组45例采用地高辛联合氢氯噻嗪与单硝酸异山梨酯治疗,观察组46例在对照组治疗基础上加用美托洛尔与依那普利,检测血清学指标,观察心功能指标,评估两组治疗效果。结果治疗前,两组血清半乳糖凝集素3(Gal-3)、氨基末端脑钠肽前体(NT-proBNP)比较,差异无统计学意义(P> 0.05),治疗3个月,观察组血清Gal-3、NT-proBNP水平低于对照组,差异有统计学意义(P <0.05);治疗前,两组心排出量(CO)、每搏输出量(SV)、左室射血分数(LVEF)比较,差异无统计学意义(P> 0.05),治疗3个月,观察组心功能指标高于对照组,差异有统计学意义(P <0.05);观察组治疗总有效率为93.48%,与对照组的77.78%比较,差异有统计学意义(P <0.05)。结论美托洛尔联合依那普利治疗CHF能降低Gal-3及NT-proBNP水平,改善心功能,疗效确切。

Objective To explore the efficacy of metoprolol combined with enalapril in treating the patients with chronic heart failure(CHF). Methods A total of 91 patients with CHF admitted to the Department of Cardiology, Bozhou District Peole’s Hospital, Zunyi City, Guizhou Province from April 2019 to December 2019 were divided into two groups through random number table method. The control group(n=45) was treated with digoxin combined with hydrochlorothiazide and isosorbide mononitrate, while the observation group(n=46) was also treated with metoprolol and enalapril on the basis of the treatment for the control group. The serological indexes were detected, the cardiac function indexes were observed, and the therapeutic effect on the two groups was respectively evaluated. Results Before treatment, there were no statistically significant differences in serum Galectin 3(Gal-3) and N-terminal pro-brain natriuretic peptide(NT-proBNP) between the two groups(P > 0.05), but after 3 m of treatment, the serum Gal-3 level and NT-proBNP level of the observation group were lower than those of the control group, and the differences were statistically significant(P < 0.0.5). Before treatment, there were no statistically significant differences in cardiac output(CO), stroke volume(SV) and left ventricular ejection fraction(LVEF) between the two groups(P > 0.05), but after 3 m of treatment, the cardiac function indexes of the observation group were higher than those of the control group, and the differences were statistically significant(P < 0.05). The total effective rate of treatment in the observation group was 93.48%, which showed statistically significant difference from the 77.78% of the control group(P < 0.05). Conclusion In treating CHF, metoprolol combined with enalapril can reduce the levels of Gal-3 and NT-proBNP and improve the cardiac function. Therefore, the efficacy is definite.