螺内酯联合曲美他嗪治疗老年慢性心力衰竭患者的效果

Effects of Spironolactone combined with Trimetazidine in treatment of elderly patients with chronic heart failure

目的:观察螺内酯联合曲美他嗪治疗老年慢性心力衰竭患者的效果。方法:回顾性分析2021年2月至2023年12月该院收治的90例老年慢性心力衰竭患者的临床资料,按照治疗方法不同将其分为研究组和对照组各45例。两组均予以常规药物治疗,在此基础上,对照组予以曲美他嗪治疗,研究组在对照组基础上联合螺内酯治疗。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)、左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD)]、炎性指标[肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)]水平,以及不良反应发生率。结果:研究组治疗总有效率为93.33%(42/45),高于对照组的71.11%(32/45),差异有统计学意义(P<0.05);治疗后,研究组LVEF水平高于对照组,LVESD、LVEDD水平低于对照组,差异均有统计学意义(P<0.05);治疗后,研究组TNF-α、hs-CRP、IL-6水平均低于对照组,差异有统计学意义(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:螺内酯联合曲美他嗪治疗老年慢性心力衰竭患者可提高治疗总有效率,改善心功能指标水平,降低炎性指标水平,效果优于单纯曲美他嗪治疗。

Objective:To observe effects of Spironolactone combined with Trimetazidine in treatment of elderly patients with chronic heart failure.Methods:The clinical data of 90 elderly patients with chronic heart failure admitted to this hospital from February 2021 to December 2023 were retrospectively analyzed.According to different treatment methods,they were divided into study group and control group,45 cases in each group.Both groups were treated with conventional drugs.On this basis,the control group was treated with Trimetazidine,while the study group was treated with Spironolactone on the basis of that of the control group.The clinical efficacy,the levels of cardiac function indexes[left ventricular ejection fraction(LVEF),left ventricular end-systolic diameter(LVESD),left ventricular end-diastolic diameter(LVEDD)]and inflammatory indexes[tumor necrosis factor-α(TNF-α),high-sensitivity C-reactive protein(hs-CRP),interleukin-6(IL-6)]before and after the treatment,and the incidence of adverse reactions were compared between the two groups.Results:The total effective rate of the study group was 93.33%(42/45),which was higher than 71.11%(32/45)of the control group,and the difference was statistically significant(P<0.05).After the treatment,the level of LVEF in the study group was higher than that in the control group,the levels of LVESD and LVEDD were lower than those in the control group,and the differences were statistically significant(P<0.05).After the treatment,the levels of TNF-α,hs-CRP and IL-6 in the study group were lower than those 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:Spironolactone combined with Trimetazidine in the treatment of the elderly patients with chronic heart failure can improve the total effective rate of treatment,improve the levels of cardiac function indexes,and reduce the levels of inflammatory indexes.Moreover,it is superior to simple Trimetazidine treatment.