单硝酸异山梨酯联合酒石酸美托洛尔对老年冠心病心绞痛患者心肌酶谱的影响

Effects of isosorbide mononitrate combined with metoprolol on myocardial enzymes in elderly patients with coronary heart disease and angina pectoris

目的探究单硝酸异山梨酯(isosorbide mononitrate,ISMN)联合酒石酸美托洛尔对老年冠心病心绞痛(coronary heart disease and angina pectoris,CHD-AP)患者血流动力学及心肌酶谱的影响。方法选取老年CHD-AP患者120例,用随机数字表法分为观察组和对照组,各60例。对照组予以ISMN治疗,观察组在对照组治疗的基础上加用酒石酸美托洛尔。连续治疗2个月后,比较2组的疗效、心绞痛发作情况、血流动力学、心肌酶谱、炎症水平变化以及不良反应发生情况。结果治疗2个月后,观察组治疗有效率高于对照组(P<0.05);治疗后2组患者心绞痛发生频率和时间、肌酸激酶(creatine kinase,CK)、肌酸激酶同工酶(creatine kinase isoenzyme,CK-MB)、乳酸脱氢酶(lactate dehydrogenase,LDH)、超敏C反应蛋白(high-sensitivity C-reactive protein,hs-CRP)以及白细胞介素-6(interleukin-6,IL-6)较治疗前均降低,且观察组低于对照组(P<0.05);2组患者每搏输出量(stroke volume,SV)、心输出量(cardiac output,CO)及左室射血分数(left ventricular ejection fractions,LVEF)较治疗前均升高,且观察组高于对照组(P<0.05);治疗期间观察组不良反应发生率低于对照组(P<0.05)。结论ISMN联合酒石酸美托洛尔治疗老年CHD-AP效果显著,能有效缓解患者的临床症状,修复受损心肌,减轻机体炎症水平,提升患者心脏功能,且安全性较高。

Objective To explore the effects of isosorbide mononitrate(ISMN)combined with metoprolol on hemodynamics and myocardial enzymes in elderly patients with coronary heart disease and angina pectoris(CHD-AP).Methods A total of 120 elderly patients with CHD-AP were enrolled and divided into observation group and control group by random number table method,60 cases in each group.The control group was treated with ISMN,while the observation group was treated with metoprolol on the basis of control group.After 2 months of continuous treatment,the curative effect,AP onset,changes of hemodynamics,myocardial enzymes and inflammation level,and the occurrence of adverse reactions were compared between the 2 groups.Results After 2 months of treatment,the response rate of treatment in observation group was higher than that in control group(P<0.05).After treatment,the frequency and duration of AP onset,the levels of creatine kinase(CK),creatine kinase isoenzyme(CK-MB),lactate dehydrogenase(LDH),high-sensitivity C-reactive protein(hs-CRP)and interleukin-6(IL-6)in the 2 groups were all decreased,which were lower in observation group than in control group(P<0.05).After treatment,the stroke volume(SV),cardiac output(CO)and left ventricular ejection fraction(LVEF)in the 2 groups were increased,which were higher in observation group than in control group(P<0.05).The incidence of adverse reactions during treatment in observation group was lower than that in control group(P<0.05).Conclusion The curative effect of ISMN combined with metoprolol is significant in the elderly with CHD-AP,which can effectively alleviate clinical symptoms,repair damaged myocardium,relieve inflammation level and enhance cardiac function,with high safety.