厄贝沙坦氢氯噻嗪联合美托洛尔治疗老年重症心力衰竭的临床疗效探讨

Clinical efficacy of irbesartan hydrochlorothiazide combined with metoprolol in the treatment of elderly patients with severe heart failure

目的 分析对老年重症心力衰竭患者采用厄贝沙坦氢氯噻嗪联合美托洛尔治疗的临床疗效。方法 选取110例老年重症心力衰竭患者为研究对象,按照双盲法将患者分为甲组和乙组,每组55例。两组均给予常规治疗,在此基础上甲组给予硝普钠治疗,乙组在甲组治疗基础上给予厄贝沙坦氢氯噻嗪联合美托洛尔治疗。比较两组治疗效果、临床症状控制时间,以及治疗前后心功能指标改善情况。结果 乙组治疗总有效率92.73%明显高于甲组的74.55%,差异有统计学意义(P<0.05)。乙组心力衰竭消失时间(5.3±1.3)d、心电图恢复正常时间(7.4±1.4)d均明显短于甲组的(8.6±2.0)、(10.1±2.5)d,差异有统计学意义(P<0.05)。治疗后,两组心率、左心室射血分数均明显优于本组治疗前,且乙组心率为(78.1±6.6)次/min、左心室射血分数为(42.7±4.9)%,明显优于甲组的(107.8±9.8)次/min、(35.8±4.7)%,差异有统计学意义(P<0.05)。结论 老年重症心力衰竭患者采用厄贝沙坦氢氯噻嗪联合美托洛尔治疗效果确切,可有效控制患者临床症状,改善心功能,具有临床推广价值。

Objective To analyze the clinical efficacy of irbesartan hydrochlorothiazide combined with metoprolol in the treatment of elderly patients with severe heart failure. Methods A total of 110 elderly patients with severe heart failure were studied and divided into group A and group B according to double-blind method,with 55 cases in each group. Both groups were given conventional treatment, on the basis of which group A was treated with nitroprusside, and group B was treated with irbesartan hydrochlorothiazide combined with metoprolol treatment on the basis of group A. The therapeutic effect, control time of clinical symptoms, and the improvement of cardiac function indexes before and after treatment were compared between the two groups. Results The total effective rate of group B was 92.73%, which was significantly higher than 74.55% of group A, and the difference was statistically significant(P<0.05). The disappearance time of heart failure(5.3±1.3) d and the recovery time of electrocardiogram(7.4±1.4) d in group B were significantly shorter than(8.6±2.0) and(10.1±2.5) d in group A, and the differences were statistically significant(P<0.05). After treatment, the heart rate and left ventricular ejection fraction of the two groups were significantly better than those of this group before treatment;group B had heart rate of(78.1±6.6) times/min and left ventricular ejection fraction of(42.7±4.9)%, which were significantly better than(107.8±9.8) times/min and(35.8±4.7)% of group A;the differences were statistically significant(P<0.05). Conclusion Irbesartan hydrochlorothiazide combined with metoprolol is effective in the treatment of elderly patients with severe heart failure, which can effectively control the clinical symptoms and improve the cardiac function of patients, and has the value of clinical promotion.