卡维地洛联合坎地沙坦治疗慢性心力衰竭合并心房颤动患者的效果

Effects of Carvedilol combined with Candesartan in treatment of patients with chronic heart failure complicated with atrial fibrillation

目的:观察卡维地洛联合坎地沙坦治疗慢性心力衰竭(CHF)合并心房颤动(AF)患者的效果。方法:回顾性分析2019—2020年佳木斯大学附属第一医院收治的112例CHF合并AF患者的临床资料,按照治疗方法不同分为对照组和观察组各56例。对照组采用坎地沙坦治疗,观察组在对照组的基础上联合卡维地洛治疗,比较两组临床疗效,治疗前后心功能指标[左房内径(LAD)、左室后壁厚度(LVPWT)、左室射血分数(LVEF)]水平,血清脑钠肽(BNP)、C反应蛋白(CRP)水平及不良反应发生率。结果:观察组治疗总有效率为94.64%,高于对照组的80.36%,差异有统计学意义(P<0.05);治疗后,观察组LAD、LVPWT水平均低于对照组,LVEF水平高于对照组,差异有统计学意义(P<0.05);观察组血清BNP、CRP水平均低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:卡维地洛联合坎地沙坦治疗CHF合并AF患者,可提高临床疗效,改善患者心功能指标水平,逆转心室重构,降低血清BNP、CRP水平,改善预后,其效果优于单纯坎地沙坦治疗。

Objective:To observe effects of Carvedilol combined with Candesartan in treatment of patients with chronic heart failure(CHF)complicated with atrial fibrillation(AF).Methods:The clinical data of 112 patients with CHF and AF admitted to the first affiliated hospital of Jiamusi university from 2019 to 2020 were retrospectively analyzed.According to different treatment methods,they were divided into control group and observation group,56 cases in each.The control group was treated with Candesartan,while the observation group was treated with Carvedilol on the basis of that of the control group.The clinical efficacy,the cardiac function index levels[left atrial diameter(LAD),left ventricular posterior wall thickness(LVPWT),left ventricular ejection fraction(LVEF)],the serum brain natriuretic peptide(BNP)and C-reactive protein(CRP)levels,and the incidence of adverse reactions were compared between the two groups before and after the treatment.Results:The total effective rate of treatment in the observation group was 94.64%,which was higher than 80.36%in the control group,and the difference was statistically significant(P<0.05).After the treatment,the levels of LAD and LVPWT in the observation group were lower than those in the control group;the level of LVEF was higher than that in the control group;and the differences were statistically significant(P<0.05).The serum BNP and CRP levels in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Carvedilol combined with Candesartan in the treatment of the patients with CHF and AF can improve the clinical efficacy,improve the levels of cardiac function indexes,reverse the ventricular remodeling,reduce the serum BNP and CRP levels,and improve the prognosis.Moreover,it is superior to single Candesartan.