美托洛尔联合硝酸异山梨酯治疗冠心病心绞痛的临床效果与安全性

Clinical efficacy and safety of metoprolol combined with isosorbide nitrate in the treatment of coronary heart disease and angina pectoris

目的 观察美托洛尔联合硝酸异山梨酯治疗冠心病心绞痛的临床效果与安全性。方法 回顾性分析2019年5月—2020年5月河池市宜州区人民医院收治的86例冠心病心绞痛患者临床资料。根据治疗方案不同分为观察组和对照组,各43例。对照组予硝酸异山梨酯片治疗,观察组在对照组基础上联合酒石酸美托洛尔片治疗,2组均连续治疗1个月。比较2组治疗效果,治疗前后心功能指标[心输出量(CO)、心搏出量(SV)、左室射血分数(LVEF)及心脏指数(CI)]变化、炎性因子[血清超敏C-反应蛋白(hs-CRP)、白介素-18(IL-18)及白介素-6(IL-6)]水平差异及不良反应。结果 观察组患者治疗总有效率为93.02%,高于对照组的72.09%(χ^(2)=6.541,P=0.011);治疗1个月后,2组CO、SV、EF及CI均较治疗前升高,且观察组高于对照组(P均<0.01);2组hs-CRP、IL-18及IL-6水平均较治疗前降低,且观察组低于对照组(P均<0.01);2组不良反应总发生率比较差异无统计学意义(P>0.05)。结论 美托洛尔联合硝酸异山梨酯治疗冠心病心绞痛的临床效果确切,能够有效改善患者心功能,减轻炎性反应,且不会明显增加不良反应发生风险,用药安全性高,值得临床推广应用。

Objective To observe the clinical effect and safety of metoprolol combined with isosorbide nitrate in the treatment of coronary heart disease and angina pectoris. Methods The clinical data of 86 patients with coronary heart disease and angina pectoris treated in Yichou District People’s Hospital of Hechi City from May 2019 to May 2020 were analyzed retrospectively. According to different treatment schemes,they were divided into observation group and control group,with 43cases in each group. The control group was treated with isosorbide nitrate tablets,and the observation group was treated with metoprolol tartrate tablets on the basis of the control group. Both groups were treated continuously for 1 month. The changes of cardiac function indexes( CO,SV,LVEF and CI),the levels of inflammatory factors( hs-CRP,IL-18 and IL-6) and adverse reactions were compared between the two groups before and after treatment. Results The total effective rate of the observation group was 93. 02%,higher than 72. 09% of the control group( χ^(2)= 6. 541,P = 0. 011). One month after treatment,the levels of CO,SV,EF and CI in the two groups were higher than those before treatment,the observation group was higher than the control group( all P < 0. 01). The levels of hs-CRP,IL-18 and IL-6 in the two groups were lower than those before treatment,the observation group was lower than the control group( all P < 0. 01). There was no significant difference in the total incidence of adverse reactions between the two groups( P > 0. 05). Conclusion Metoprolol combined with isosorbide nitrate is effective in the treatment of coronary heart disease and angina pectoris. It can effectively improve patients’ cardiac function,reduce inflammatory reaction and will not increase the risk of adverse reactions. It has high drug safety and is worthy of clinical application.