曲美他嗪联合美托洛尔治疗冠心病心力衰竭对血浆BNP影响及疗效

Effects of Trimetazidine Combined with Metoprolol on Plasma BNP in the Treatment of Coronary Heart Disease and Heart Failure

目的探讨曲美他嗪联合美托洛尔治疗冠心病心力衰竭对血浆BNP的影响及疗效。方法选取2017年3月—2020年2月兴化市人民医院收治的98例冠心病心力衰竭患者为研究对象。采取随机数表法均分为对照组和观察组,对照组49例患者采取美托洛尔及常规治疗,观察组49例患者在对照组基础上加用曲美他嗪治疗。比较两组患者治疗后心率(HR)、血浆脑钠肽(BNP)、射血分数(LVEF)心功能指标、内皮功能指标及不良反应情况。结果治疗后,观察组LVEF(58.22±16.24)%高于对照组,HR(71.42±2.49)次/min及血浆BNP(221.47±18.43)pg/mL明显低于对照组,差异有统计学意义(t=2.354、6.961、45.362,P<0.05);观察组ET-I水平(91.25±13.31)ng/L低于对照组,NO水平(78.31±19.28)mmol/L高于对照组,差异有统计学意义(t=10.810、8.819,P<0.05);观察组不良反应发生率6.12%(3/49)与对照组12.24%(6/49)比较,差异无统计学意义(χ^(2)=0.489,P>0.05)。结论针对冠心病心力衰竭患者采取曲美他嗪联合美托洛尔治疗可同步改善心功能及血管内皮指标,不会增加不良反应,值得临床推广应用。

Objective To investigate the effect and efficacy of trimetazidine combined with metoprolol on plasma BNP in the treatment of coronary heart disease and heart failure.Methods A total of 98 patients with coronary heart disease and heart failure admitted to the Xinghua People’s Hospital from March 2017 to February 2020 were selected as the research objects.The patients were divided into control group and observation group by random number table method.49 patients in control group were treated with metoprolol and conventional treatment,and 49 patients in observation group were treated with trimetazidine on the basis of control group.The cardiac function indexes og heart rate(HR),plasma brain natriuretic peptide(BNP),ejection fraction(LVEF),endothelial function indexes and adverse reactions were compared between the two groups after treatment.Results After treatment,LVEF(58.22±16.24)%in the observation group was higher than that in the control group,HR(71.42±2.49)times/min and plasma BNP(221.47±18.43)pg/mL were significantly lower than those in the control group,and the difference was statistically significant(t=2.354,6.961,45.362,P<0.05);the level of ET-1 in the observation group was(91.25±13.31)ng/L lower than that in the control group,and the level of NO(78.31±19.28)mmol/L was higher than that in the control group,and the difference was statistically significant(t=10.810,8.819,P<0.05);the incidence of adverse reactions in the observation group was 6.12%(3/49)compared with 12.24%(6/49)in the control group,and the difference was not statistically significant(χ^(2)=0.489,P>0.05).Conclusion Trimetazidine combined with metoprolol can simultaneously improve cardiac function and vascular endothelial indexes in patients with coronary heart disease and heart failure,without increasing the occurrence of adverse reactions,which is worthy of promotion.