ACEI类药物联合β受体阻滞剂改善扩张型心肌病伴心力衰患者的预后分析

Analysis of ACEI drugs combined with β-blocker in improving the prognosis of patients with dilated cardiomyopathy complicated with heart failure

目的探讨ACEI类药物联合β受体阻滞剂综合治疗扩张型心肌病伴心力衰竭患者的治疗效果,为临床治疗提供参考。方法采用临床对照研究,以扩张型心肌病伴心力衰竭患者为研究对象,依据心功能严重程度,采用分层区组法随机分为观察组与常规组。观察组患者予以盐酸贝那普利片联合小剂量琥珀酸美托洛尔缓释片,对照组则予以盐酸贝那普利片联合利尿剂治疗。治疗结束后比较两组心功能变化情况,统计期间不良反应发生率。结果 33例观察组病例治疗总有效率为93.94%,显著高于34例常规组病例的76.47%(P<0.05);治疗后观察组LVDd(6.07±0.11cm)与常规组LVDd(6.08±0.15cm)无显著差异(P>0.05);观察组LAD(3.61±0.25cm)显著低于常规组LAD(3.97±0.16cm),观察组EF(49.83±3.69%)则显著高于常规组(42.53±1.75%)(P <0.05);治疗后观察组BNP(406.71±47.39 pg/mL)显著低于常规组(472.68±32.16 pg/mL),观察组6MWT(203.74±27.14 cm)显著高于常规组(134.58±24.53 cm)(P <0.05)。但观察组不良反应总发生率(21.21%)与常规组(29.41%)无显著差异(P>0.05)。结论 ACEI类药物联合β受体阻滞剂综合治疗扩张型心肌病伴心力衰竭患者的疗效较好,可充分改善患者的心功能,且未增加不良反应,有效性及安全性良好。

Objective To explore the therapeutic effect of ACEI drugs combined with β-blocker in the treatment of patients with dilated cardiomyopathy complicated with heart failure, so as to provide a reference for clinical treatment. Methods Using a clinically controlled study, patients with dilated cardiomyopathy complicated with heart failure were selected as the study subjects. According to the severity of cardiac function, the patients were randomly divided into the observation group and the conventional group by stratified block method. Patients in the observation group were treated with benazepril hydrochloride tablets combined with low-dose metoprolol succinate sustained-release tablets, and patients in the conventional group were given benazepril hydrochloride tablets combined with diuretics. After the end of treatment, the changes of cardiac function were compared between the two groups, and the incidence rates of adverse reactions during treatment were compared. Results The total effective rate of 33 cases treatment in the observation group was higher than 34 cases in the conventional group(93.94% vs 76.47%, P < 0.05). There was no significant difference in the LVDd after treatment between the observation group and the conventional group(6.07 ± 0.11 cm vs 6.08 ± 0.15 cm, P > 0.05). The LAD of the observation group was significantly lower than that of the conventional group(3.61 ± 0.25 cm vs 3.97 ± 0.16 cm, P < 0.05), and the EF was significantly higher than that of the conventional group(49.83 ± 3.69% vs 42.53 ± 1.75%, P < 0.05). The BNP of the observation group after treatment was significantly lower than that of the conventional group(406.71 ± 47.39 pg/m L vs 472.68 ± 32.16 pg/m L, P < 0.05), and the 6 MWT was significantly higher than that of the conventional group(203.74 ± 27.14 cm vs 134.58 ± 24.53 cm, P < 0.05). There was no statistically significant difference in the total incidence rate of adverse reactions between the observation group and the conventional group(21.21% vs29.41%, P > 0.05). Conclusion ACEI drugs combined with β-blocker has good efficacy in the treatment of patients with dilated cardiomyopathy complicated with heart failure, and can fully improve the cardiac function of patients without increasing adverse reactions,and it has good effectiveness and safety.