美托洛尔联合厄贝沙坦氢氯噻嗪治疗老年重症心力衰竭的临床效果

Clinical Effect of Metoprolol Combined with Irbesartan Hydrochlorothiazide in the Treatment of Elderly with Severe Heart Failure

目的:探讨美托洛尔联合厄贝沙坦氢氯噻嗪治疗老年重症心力衰竭的临床效果。方法:将邳州市中医院2022年1月—2023年12月收治的70例老年重症心力衰竭患者随机分为对照组(美托洛尔治疗)和观察组(美托洛尔联合厄贝沙坦氢氯噻嗪治疗),各35例。对比两组治疗效果及心功能指标。结果:观察组治疗总有效率高于对照组(P=0.032)。治疗前,两组氨基末端脑钠肽前体(NT-proBNP)、心肌营养因子-1(Ct-1)、可溶性细胞间黏附分子-1(sICAM-1)、心输出量(CO)、每搏输出量(SV)、左室射血分数(LVEF)、二尖瓣舒张早期峰值流速/二尖瓣舒张晚期峰值流速(E/A)水平对比,无统计学差异(P>0.05);治疗后,两组NT-proBNP、Ct-1、sICAM-1水平降低,CO、SV、LVEF、E/A水平升高,观察组NT-proBNP、Ct-1、sICAM-1水平低于对照组,CO、SV、LVEF、E/A水平高于对照组(P<0.05)。结论:美托洛尔联合厄贝沙坦氢氯噻嗪治疗老年重症心力衰竭更有效,可以提高患者的心功能指标。

Objective:To explore the clinical effect of metoprolol combined with irbesartan hydrochlorothiazide in the treatment of severe heart failure in the elderly.Methods:Seventy cases of elderly patients with severe heart failure admitted to Pizhou Hospital of Traditional Chinese Medicine from January 2022 to December 2023 were randomly divided into the control group(metoprolol treatment)and the observation group(metoprolol and irbesartan hydrochlorothiazide treatment),each with thirty-five cases.Compared the treatment effect and cardiac function indexes of the two groups.Results:The total effective rate of treatment in the observation group was higher than that in the control group(P=0.032).Before treatment,the levels of amino-terminal brain natriuretic peptide precursor(NT-proBNP),cardiac trophic factor-1(Ct-1),soluble intercellular adhesion molecule-1(sICAM-1),cardiac output(CO),stroke volume(SV),left ventricular ejection fraction(LVEF),and mitral valve peak flow rate in early diastole/peak flow rate in late diastole(E/A)were compared between the two groups,and the differences were not statistically significant(P>0.05);after treatment,the levels of NT-proBNP,Ct-1 and sICAM-1 decreased and the levels of CO,SV,LVEF and E/A increased in the two groups,and the levels of NT-proBNP,Ct-1 and sICAM-1 in the observation group were lower than those in the control group,and the levels of CO,SV,LVEF and E/A were higher than those in the control group(P<0.05).Conclusion:Metoprolol combined with irbesartan hydrochlorothiazide is more effective in the treatment of severe heart failure in the elderly,and can improve patients'cardiac function.