曲美他嗪联合美托洛尔治疗冠心病合并慢性心力衰竭的效果观察

Efficacy of Trimetazidine Combined with Metoprolol in the Treatment of Coronary Heart Disease Complicated with Chronic Heart Failure

目的:观察曲美他嗪联合美托洛尔治疗冠心病合并慢性心力衰竭(CHF)的临床价值。方法:选取2021年7月—2023年7月北京市昌平区中西医结合医院收治的冠心病合并CHF患者80例为研究对象,采用随机数表法分为对照组和观察组,各40例。对照组采用曲美他嗪治疗,观察组采用美托洛尔联合曲美他嗪治疗。比较两组治疗效果、临床相关指标及血管内皮功能。结果:观察组治疗总有效率高于对照组,差异有统计学意义(P=0.023)。治疗后,两组24 h平均心率降低,观察组低于对照组,两组左室射血分数、6 min步行试验距离增加,观察组高于对照组,差异有统计学意义(P<0.05)。治疗后,两组一氧化氮、降钙素基因相关肽水平升高,观察组高于对照组,两组血浆内皮素水平降低,观察组低于对照组,差异有统计学意义(P<0.05)。结论:曲美他嗪联合美托洛尔治疗冠心病合并CHF效果显著,可改善心功能,调节血管内皮相关因子水平。

Objective:To observe the clinical value of trimetazidine combined with metoprolol in the treatment of coronary heart disease complicated with chronic heart failure(CHF).Methods:A total of 80 patients with CHF and CHD were selected as the study objects at Changping District Hospital of Traditional Chinese and Western Medicine from July 2021 to July 2023,and were divided into control group and observation group by random number table method,with 40 cases in each group.The control group was treated with trimetazidine,and the observation group was treated with metoprolol combined with trimetazidine.The therapeutic effect,clinical indexes and vascular endothelial function were compared between the two groups.Results:The total effective rate of the observation group was higher than that of the control group,the difference was statistically significant(P=0.023).After treatment,the 24 h mean heart rate of the two groups decreased,the observation group was lower than the control group,the left ventricular ejection fraction and the 6 min walking test distance of the two groups were increased,and the observation group was higher than the control group,the difference was statistically significant(P<0.05).After treatment,the levels of nitric oxide and calcitonin gene-related peptide in two groups were increased,the observation group was higher than the control group,the plasma endothelin level in two groups was decreased,the observation group was lower than the control group,the difference was statistically significant(P<0.05).Conclusion:Trimetazidine combined with metoprolol is effective in the treatment of coronary heart disease complicated with CHF,which can improve cardiac function and regulate the level of vascular endothelial related factors.