曲美他嗪联合美托洛尔治疗冠心病合并心力衰竭患者的效果

Effects of Trimetazidine combined with Metoprolol in treatment of patients with coronary heart disease complicated with heart failure

目的:观察曲美他嗪联合美托洛尔治疗冠心病合并心力衰竭患者的效果。方法:回顾性分析2020年5月至2023年3月该院收治的60例冠心病合并心力衰竭患者的临床资料,按照治疗方法不同将其分为对照组和观察组各30例。两组均进行常规治疗,在此基础上,对照组予以美托洛尔治疗,观察组在对照组基础上联合曲美他嗪治疗,两组均持续治疗2个月。比较两组临床疗效,治疗前后心功能指标[左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)]水平、心肌纤维化指标[Ⅲ型前胶原氨基端肽(PⅢNP)、Ⅰ型前胶原羧基端肽(PⅠCP)、Ⅰ型胶原交联羧基末端肽(ⅠCTP)]水平、氧化应激指标[丙二醛(MDA)、超氧化物歧化酶(SOD)]水平、血管内皮功能指标[内皮素-1(ET-1)、血管内皮生长因子(VEGF)]水平,以及不良反应发生率。结果:观察组治疗总有效率为93.33%(28/30),高于对照组的66.67%(20/30),差异有统计学意义(P<0.05);治疗后,观察组LVEDD、LVESD水平低于对照组,LVEF水平高于对照组,差异均有统计学意义(P<0.05);治疗后,观察组PⅢNP、PⅠCP、ⅠCTP水平均低于对照组,差异有统计学意义(P<0.05);治疗后,观察组MDA水平低于对照组,SOD水平高于对照组,差异均有统计学意义(P<0.05);治疗后,观察组ET-1水平低于对照组,VEGF水平高于对照组,差异均有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:曲美他嗪联合美托洛尔治疗冠心病合并心力衰竭患者可提高治疗总有效率,改善心功能指标、氧化应激指标和血管内皮功能指标水平,效果优于单纯美托洛尔治疗。

Objective:To observe effects of Trimetazidine combined with Metoprolol in treatment of patients with coronary heart disease complicated with heart failure.Methods:The clinical data of 60 patients with coronary heart disease and heart failure admitted to this hospital from May 2020 to March 2023 were retrospectively analyzed.According to different treatment methods,they were divided into control group and observation group,30 cases in each group.Both groups received routine treatment.On this basis,the control group was treated with Metoprolol,while the observation group was treated with Trimetazidine on the basis of that of the control group.Both groups were treated for 2 months.The clinical efficacy,the levels of cardiac function indexes[left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD)],myocardial fibrosis indexes[type III procollagen amino terminal peptide(PIIINP),type I procollagen carboxy terminal peptide(PICP),type I collagen cross-linked carboxyl terminal peptide(ICTP)]and oxidative stress indexes[malondialdehyde(MDA),superoxide dismutase(SOD)],vascular endothelial function indexes[endothelin-1(ET-1),vascular endothelial growth factor(VEGF)]before and after the treatment,and the incidence of adverse reactions were compared between the two groups.Results:The total effective rate of the observation group was 93.33%(28/30),which was higher than 66.67%(20/30)of the control group,and the difference was statistically significant(P<0.05).After the treatment,the levels of LVEDD and LVESD in the observation group were lower than those in the control group,the level of LVEF was higher than that in the control group,and the differences were statistically significant(P<0.05).After the treatment,the levels of PIIINP,PICP and ICTP in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).After the treatment,the MDA level in the observation group was lower than that in the control group,the SOD level was higher than that in the control group,and the differences were statistically significant(P<0.05).After the treatment,the level of ET-1 in the observation group was lower than that in the control group,the level of VEGF was higher than that in the control group,and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Trimetazidine combined with Metoprolol can improve the total effective rate and the levels of cardiac function indexes,oxidative stress indexes and vascular endothelial function indexes in the patients with coronary heart disease complicated with heart failure.Moreover,it is superior to single Metoprolol treatment.