厄贝沙坦联合美托洛尔治疗慢性充血性心衰的临床效果及对患者心功能影响

Clinical effect of irbesartan combined with metoprolol in the treatment of chronic congestive heart failure and its influence on cardiac function

目的分析厄贝沙坦+美托洛尔治疗慢性充血性心力衰竭(congestive heart failure,CHF)的临床效果及对患者心功能影响。方法选取本院2018年12月-2020年12月住院治疗的200例慢性CHF患者,根据不同的治疗方法分组,参照组100例患者采用厄贝沙坦治疗,治疗组100例患者采用厄贝沙坦+美托洛尔治疗,比较2组临床疗效、心功能指标、血清炎性因子、血清N端脑利钠肽前体(N-terminal pro-brain natriuretic peptide,NT-proBNP)、同型半胱氨酸(homocysteine,Hcy)水平、不良反应发生率。结果治疗组临床总有效率(97.00%)高于参照组(87.00%),治疗组治疗后左室射血分数(left ventricular ejection fraction,LVEF)高于参照组,治疗组治疗后左室舒张末期内径(left ventricular end diastolic diameter,LVEDd)、左室收缩末期内径(left ventricular end systolic diameter,LVESd)、血清肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、超敏C反应蛋白(hypersensitivity C-reactive protein,hs-CRP)、白细胞介素-6(interleukin-6,IL-6)、NT-proBNP、Hcy水平均低于参照组,差异均具有统计学意义(P<0.05)。治疗组不良反应发生率(4.00%)与参照组(5.00%)比较,P>0.05。结论厄贝沙坦+美托洛尔可有效改善慢性CHF患者心功能,减轻炎症反应,抑制NT-proBNP、Hcy释放,且不良反应较少。

Objective To analyze the clinical effect of irbesartan combined with metoprolol in the treatment of chronic congestive heart failure(CHF)and its influence on cardiac function.Methods A total of 200 patients with chronic CHF in our hospital from December 2018 to December 2020 were selected and divided into two groups according to different treatment methods.One handred patients in the control group were treated with irbesartan,and 100 patients in the treatment group were treated with irbesartan+metoprolol.The clinical efficacy,cardiac function indexes,serum inflammatory factors,serum NT-proBNP,Hcy levels and adverse reactions of the two groups were compared.Results The total effective rate of the treatment group(97.00%)was higher than that of the control group(87.00%),LVEF of the treatment group was higher than that of the control group,LVEDd,LVESd,serum TNF-α,hs-CRP,IL-6,NT-proBNP,Hcy levels of the treatment group were lower than those of the control group,the differences were statistically significant(P<0.05).The incidence of adverse reactions in the treatment group(4.00%)was higher than that in the control group(5.00%),P>0.05.Conclusion Irbesartan+metoprolol could effectively improve cardiac function,reduce inflammatory reaction,inhibit the release of NT-proBNP and Hcy in patients with chronic CHF,with less adverse reactions.