美托洛尔联合曲美他嗪治疗对冠心病合并慢性心力衰竭血浆脑钠肽及血管内皮功能的影响

Effect of metoprolol combined with trimetazidine on the plasma brain natriuretic peptide and vascular endothelial function in patients with coronary heart disease complicated with chronic heart failure

目的探讨冠心病(CHD)合并慢性心力衰竭(CHF)患者服用美托洛尔联合曲美他嗪对血浆脑钠钛和血管内皮功能的影响。方法回顾性选取普宁市人民医院2019年3月至2020年12月就诊的80例CHD合并CHF患者,按治疗方法分为对照组(n=38)和观察组(n=42)。对照组给予美托洛尔治疗,观察组在对照组的基础上同时给予盐酸曲美他嗪治疗。观察两组患者8周后的治疗效果,观察两组治疗前后的血清因子、血管内皮功能、血浆脑钠肽以及心功能的水平变化。结果观察组治疗后的总有效率明显高于对照组,差异有统计学意义(P<0.05)。观察组治疗后心功能指标(LVEF)水平较治疗前升高,差异有统计学意义(P<0.05)。观察组血浆脑钠肽(BNP)、左室收缩末期内径(LVESD)、左室舒张末期内径(LVEDD)水平较治疗前明显降低,差异有统计学意义(P<0.05)。两组治疗前血清白介素-6(IL-6)、血清白介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)水平比较,差异无统计学意义(P>0.05)。治疗后观察组血清IL-6、IL-10、TNF-α水平明显低于对照组,差异有统计学意义(P<0.05)。治疗后观察组血清内皮素(ET-1)、C-反应蛋白(CRP)水平较治疗前明显降低,一氧化氮(NO)水平较治疗前升高,差异有统计学意义(P<0.05)。结论CHD合并CHF患者服用美托洛尔联合曲美他嗪可以稳定血浆脑钠肽水平,改善血管内皮功能及心功能,提高临床治疗效果。

Objective To investigate the effect of metoprolol combined with trimetazidine on the plasma brain natriuretic peptide(BNP)and vascular endothelial function for patients with coronary heart disease(CHD)comp licated with chronic heart failure(CHF).Methods A total of 80 patients with CHD complicated with CHF in Puning People's Hospital from March 2019 to December 2020 were retrospectively selected and divided into the control group(n=38)and the observation group(n=42)according to the treatment method.The control group was treated with metoprolol tablets,and the observation group was treated with trimetazidine hydrochloride on the basis of the same treatment in the control group.The treatment effect after 8 weeks of treatment,the level of changes in serum factors,vascular endothelial function and cardiac function before and after treatment were observed in the two groups.Results The total effective rate in the observation group after treatment was significantly higher than that in the control group,with statistically significant difference(P<0.05).The level of cardiac function index(LVEF)in the observation group increased after treatment compared with before treatment,with statistically significant difference(P<0.05).The levels of plasma BNP,left ventricular end-systolic diameter(LVESD),and left ventricular enddiastolic diameter(LVEDD)in the observation group after treatment were significantly lower than those before treatment,with statistically significant differences(P<0.05).Before treatment,there were no statistically significant differences in the levels of serum interleukin-6(IL-6),serum interleukin-10(IL-10)and tumor necrosis factor-α(TNF-α)between the two groups(P>0.05).After treatment,the levels of serum IL-6,IL-10,and TNF-αin the observation group were significantly lower than those in the control group,with statistically significant differences(P<0.05).The levels of serum endothelin(ET-1)and C-reactive protein(CRP)in the observation group after treatment were significantly lower than those before treatment,the nitric oxide(NO)level after treatment was higher than that before treatment and the differences were statistically significant between the observation group and the control group(P<0.05).Conclusion Metoprolol combined with trimetazidine can stabilize plasma BNP levels,improve vascular endothelial function and cardiac function,and enhance clinical therapeutic effects of patients with CHD complicated with CHF.