硝酸异山梨酯氯化钠注射液联合酒石酸美托洛尔缓释片(Ⅱ)治疗缺血性心肌病的临床效果

Clinical effect of isosorbide dinitrate and sodium chloride injection combined with metoprolol tartrate sustained-release tablets(Ⅱ)in the treatment of ischemic cardiomyopathy

目的观察硝酸异山梨酯氯化钠注射液联合酒石酸美托洛尔缓释片(Ⅱ)治疗缺血性心肌病的临床效果。方法选取2023年4—12月黔东南州人民医院收治的缺血性心肌病患者540例,按照入院顺序分为观察组和对照组各270例。在常规治疗基础上,对照组应用酒石酸美托洛尔缓释片(Ⅱ)治疗,观察组在对照组基础上加用硝酸异山梨酯氯化钠注射液治疗,2组疗程均为1个月。比较2组治疗前后心功能指标[左室射血分数(LVEF)、心输出量(CO)、左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)]、心肌标志物[脑钠肽(BNP)、胰岛素样生长因子-1(IGF-1)、肌钙蛋白T(cTnT)],不良反应及不良心血管事件。结果观察组治疗总有效率为98.52%,高于对照组的92.59%(χ^(2)=11.163,P=0.001)。治疗1个月后,2组LVEF、CO高于治疗前,LVEDD、LVESD短于治疗前,且观察组高/短于对照组(P<0.01);2组BNP、cTnT水平低于治疗前,IGF-1水平高于治疗前,且观察组低/高于对照组(P<0.01)。观察组与对照组不良反应总发生率比较差异无统计学意义(1.85%vs.3.33%,χ^(2)=1.173,P=0.279)。观察组不良心血管事件总发生率为2.96%,低于对照组的7.78%(χ^(2)=6.158,P=0.013)。结论硝酸异山梨酯氯化钠注射液联合酒石酸美托洛尔缓释片(Ⅱ)治疗缺血性心肌病效果显著,可明显改善患者心功能及实验室指标,安全性高,且可降低不良心血管事件发生风险。

Objective To observe the clinical effect of isosorbide dinitrate and sodium chloride injection combined with metoprolol tartrate sustained-release tablets(Ⅱ)in the treatment of ischemic cardiomyopathy.Methods A total of 540 patients with ischemic cardiomyopathy admitted to Qiandongnan People′s Hospital from April to December 2023 were selected and divided into observation group and control group according to the order of admission,with 270 cases in each group.On the basis of conventional treatment,the control group was treated with metoprolol tartrate sustained-release tablets(Ⅱ),and the observation group was treated with isosorbide dinitrate and sodium chloride injection on the basis of the control group.Both groups were treated for 1 month.The cardiac function indexes(LVEF,CO,LVEDD,LVESD)and cardiac markers(BNP,IGF-1,cTnT)before and after treatment,adverse reactions and adverse cardiovascular events were compared between the two groups.Results The total effective rate of the observation group was 98.52%,which was higher than 92.59%of the control group(χ^(2)=11.163,P=0.001).After 1 month of treatment,LVEF and CO in the two groups were higher than those before treatment,LVEDD and LVESD were shorter than those before treatment,and the observation group were higher/shorter than the control group(P<0.01).The levels of BNP and cTnT in the two groups were lower than those before treatment,and the levels of IGF-1 were higher than those before treatment,and the observation group was lower/higher than the control group(P<0.01).There was no significant difference in the total incidence of adverse reactions between the observation group and the control group(1.85%vs.3.33%,χ^(2)=1.173,P=0.279).The total incidence of adverse cardiovascular events in the observation group was 2.96%,which was lower than 7.78%in the control group(χ^(2)=6.158,P=0.013).Conclusion Isosorbide dinitrate and sodium chloride injection combined with metoprolol tartrate sustained-release tablets(Ⅱ)is effective in the treatment of ischemic cardiomyopathy,which can significantly improve cardiac function and laboratory indicators of patients,with high safety,and can reduce the risk of adverse cardiovascular events.