福辛普利钠联合比索洛尔、螺内酯对老年冠心病心力衰竭患者心功能、血脂代谢的影响

Influence of fosinopril sodium combined bisoprolol,spironolactone on cardiac function and blood lipid metabolism in aged patients with CHD and HF

目的:探讨福辛普利钠联合富马酸比索洛尔、螺内酯对老年冠心病心力衰竭患者心功能、血脂代谢的影响。方法:我院的96例老年冠心病心力衰竭患者,被均为二联治疗组(富马酸比索洛尔+螺内酯治疗)和三联治疗组(福辛普利钠+富马酸比索洛尔+螺内酯治疗)。两组患者在对症基础治疗上给予相应治疗方案。治疗6个月后,比较两组患者治疗前后心功能、血脂、血清N末端脑钠肽前体(NT-proBNP)等指标变化情况。结果:治疗6个月后,与二联治疗组比较,三联治疗组左室射血分数(LVEF)[(44.42±7.09)%比(50.31±8.25)%]、左室短轴缩短率(LVFS)[(17.03±3.05)%比(19.12±3.34)%]及血清HDL-C[(1.12±0.16)mmol/L比(1.23±0.19)mmol/L]水平显著提高,左室收缩末期内径(LVESd)[(37.46±5.01)mm比(32.48±4.42)mm]、左室舒张末期内径(LVEDd)[(50.28±5.39)mm比(46.14±4.87)mm]显著缩小,血清TC[(4.34±0.87)mmol/L比(3.11±0.64)mmol/L]、TG[(2.23±0.26)mmol/L比(1.72±0.21)mmol/L]、LDL-C[(2.81±0.43)mmol/L比(2.13±0.37)mmol/L]、NT-proBNP[(1342.56±214.07)mmol/L比(886.91±165.43)mmol/L]水平均显著降低(P均<0.01)。结论:福辛普利钠联合富马酸比索洛尔、螺内酯治疗可显著改善老年冠心病心力衰竭患者心功能、血脂代谢。

Objective:To explore influence of fosinopril sodium combined bisoprolol fumarate,spironolactone on cardiac function and blood lipid metabolism in aged patients with coronary heart disease(CHD)and heart failure(HF).Methods:A total of 96 aged CHD+HF patients treated in our hospital were randomly and equally divided into dual-therapy group(bisoprolol fumarate+spironolactone)and triple-therapy group(received fosinopril sodium combined+bisoprolol fumarate+spironolactone).Each group received corresponding treatment based on symptomatic treatment for six months.Cardiac function indexes,blood lipids,serum N terminal pro brain natriuretic peptide(NT-proBNP)were compared between two groups before and six months after treatment.Results:Compared with dual-therapy group after six months,there were significant rise in LVEF[(44.42±7.09)%vs.(50.31±8.25)%],left ventricular fractional shortening(LVFS)[(17.03±3.05)%vs.(19.12±3.34)%]and serum HDL-C level[(1.12±0.16)mmol/L vs.(1.23±0.19)mmol/L],and significant reductions in left ventricular end-systolic dimension(LVESd)[(37.46±5.01)mm vs.(32.48±4.42)mm],left ventricular end-diastolic dimension(LVEDd)[(50.28±5.39)mm vs.(46.14±4.87)mm],serum levels of TC[(4.34±0.87)mmol/L vs.(3.11±0.64)mmol/L],TG[(2.23±0.26)mmol/L vs.(1.72±0.21)mmol/L],LDL-C[(2.81±0.43)mmol/L vs.(2.13±0.37)mmol/L]and NT-proBNP[(1342.56±214.07)mmol/L vs.(886.91±165.43)mmol/L]in triple-therapy group,P<0.01 all.Conclusion:Fosinopril sodium combined bisoprolol fumarate and spironolactone can significantly improve cardiac function,blood lipid metabolism in aged CHD+HF patients.