美托洛尔联合曲美他嗪治疗冠心病合并心衰的临床效果分析

Clinical effect analysis of metoprolol combined with trimetazidine in the treatment of coronary heart disease complicated with heart failure

目的 分析冠心病伴心力衰竭(心衰)患者实施美托洛尔联合曲美他嗪治疗的临床价值。方法 74例冠心病合并心衰患者,采用随机数字表法分为对照组和观察组,每组37例。对照组应用美托洛尔治疗,观察组在对照组基础上联合曲美他嗪治疗。比较两组临床疗效、心功能指标、6 min步行距离(6MWD)、心率(HR)及不良反应发生情况。结果 治疗前,两组左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)与左心室收缩末期内径(LVESD)对比差异无统计学意义(P>0.05);治疗后,观察组LVEF(55.26±5.96)%高于对照组的(44.19±6.06)%,LVEDD(42.63±3.95)mm、LVESD(36.25±3.06)mm小于对照组的(50.85±5.16)、(40.59±3.79)mm,差异有统计学意义(P<0.05)。治疗前,两组6MWD、HR对比差异无统计学意义(P>0.05);治疗后,观察组6MWD(395.26±67.19)m长于对照组的(297.89±56.32)m,HR(76.15±7.29)次/min低于对照组的(88.69±6.69)次/min,差异有统计学意义(P<0.05)。观察组治疗总有效率94.59%高于对照组的78.38%,差异有统计学意义(P<0.05)。两组不良反应发生率对比差异无统计学意义(P>0.05)。结论 冠心病合并心衰患者实施美托洛尔和曲美他嗪联合治疗可获得比较确切的临床疗效,有利于改善患者心功能并提升运动耐力,且用药安全性良好。

Objective To analyze the clinical value of metoprolol combined with trimetazidine in the treatment of coronary heart disease complicated with heart failure.Methods A total of 74 patients with coronary heart disease and heart failure were divided into control group and observation group according to the random numerical table,with 37 cases in each group.The control group was treated with metoprolol,and the observation group was treated with trimetazidine on the basis of the control group.The clinical efficacy,cardiac function indicators,6-min walking distance(6MWD),heart rate(HR)and the incidence of adverse reactions were compared between the two groups.Results Before treatment,there were no statistically significant differences in left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD)and left ventricular end-systolic diameter(LVESD)between the two groups(P>0.05).After treatment,LVEF of(55.26±5.96)%in the observation group was higher than that of(44.19±6.06)%in the control group;LVEDD of(42.63±3.95)mm and LVESD of(36.25±3.06)mm in the observation group were less than those of(50.85±5.16)and(40.59±3.79)mm in the control group;the differences were statistically significant(P<0.05).Before treatment,there was no statistically significant difference in 6MWD and HR between the two groups(P>0.05).After treatment,6MWD of(395.26±67.19)min the observation group was longer than that of(297.89±56.32)m in the control group,and HR of(76.15±7.29)beats/min was lower than that of(88.69±6.69)beats/min in the control group.The differences were statistically significant(P<0.05).The total effective rate of 94.59%in the observation group was higher than that of 78.38%in the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Metoprolol and trimetazidine combined treatment for patients with coronary heart disease and heart failure can obtain a relatively accurate clinical effect,which is beneficial to improve the cardiac function of patients and improve exercise endurance with high drug safety.