美托洛尔联合曲美他嗪在冠状动脉粥样硬化性心脏病合并Ⅲ~Ⅳ级心功能不全治疗中的应用价值

The Application Value of Metoprolol Combined with Trimetazidine in the Treatment of Coronary Atherosclerotic Heart Disease Complicated withⅢ~ⅣCardiac Insufficiency

目的 探讨美托洛尔联合曲美他嗪治疗冠心病伴Ⅲ~Ⅳ级心力衰竭患者的效果。方法 选择永昌县人民医院2020年6—12月收治的冠心病伴Ⅲ~Ⅳ级心力衰竭患者110例,随机分为对照组和观察组各55例。对照组接受常规药物干预,观察组在其基础上加用美托洛尔和曲美他嗪。比较两组患者的心功能、血清学指标、心脏重塑指标和治疗满意率。结果 治疗后,观察组心功能分级改善情况优于对照组,差异有统计学意义(P<0.05)。观察组心房利钠肽、脑利钠肽、高敏C反应蛋白、左心室收缩末期内经和左心室舒张末期内径低于对照组;而左室射血分数高于对照组,差异有统计学意义(P<0.05)。观察组总满意率高于对照组,差异有统计学意义(P<0.05)。结论 美托洛尔联合曲美他嗪能够进一步改善冠心病伴Ⅲ~Ⅳ级心力衰竭患者的治疗效果,值得临床推广应用。

Objective To explore the efficacy of metoprolol combined with trimetazidine in the treatment of coronary heart disease patients complicated with grade III~IV heart failure.Methods A total of 110 patients with coronary heart disease complicated with grade III~IV heart failure admitted to Yongchang County People's Hospital from June to December 2020 were randomly divided into a control group and an observation group,with 55 cases in each group.The control group received routine drug intervention,while the observation group received metoprolol and trimetazidine based on routine treatment.The cardiac function,serological indicators,cardiac remodeling indicators,and treatment satisfaction rates were compared between two groups.Results After treatment,the improvement in cardiac function grading in the observation group was significantly better than that in the control group(P<0.05).The observation group had significantly lower atrial natriuretic peptide,brain natriuretic peptide,high-sensitivity protein,C-reactive protein,left ventricular end systolic diastolic diameter,left ventricular diastolic diameter and higher left ventricular ejection fraction compared to the control group(P<0.05).The overall satisfaction rate of the observation group was significantly higher than that of the control group(P<0.05).Conclusion The application of metoprolol and trimetazidine can further improve the treatment effect of coronary heart disease patients complicated with grade III~IV heart failure,and is worthy of clinical promotion and application.