曲美他嗪联合琥珀酸美托洛尔治疗冠心病心力衰竭的疗效观察

Observation on Efficacy of Trimetazidine Combined with Metoprolol Succinate in Treatment of Heart Failure of Coronary Heart Disease

目的:探讨曲美他嗪联合琥珀酸美托洛尔治疗冠心病心力衰竭的临床疗效。方法:选取2015年1月至2016年10月抚顺矿务局总医院收治的冠心病心力衰竭患者90例,以随机数字表法分为观察组和对照组,每组45例。对照组患者在常规治疗的基础上给予琥珀酸美托洛尔治疗,观察组患者在对照组的基础上加用曲美他嗪治疗。两组患者均治疗12周。比较两组患者治疗前后的血压、心率、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、左心室射血分数(LVEF)及脑钠肽(BNP)水平的差异。结果:治疗后,两组患者收缩压、舒张压及心率较治疗前明显降低,且观察组患者明显低于对照组,差异均有统计学意义(P<0.05);治疗后,两组患者LVEDD、LVESD水平较治疗前明显降低,LVEF水平明显升高,且观察组患者明显优于对照组,差异均有统计学意义(P<0.05);治疗后,观察组、对照组患者平均BNP水平分别为(221.62±10.84)、(268.25±11.42) pg/ml,均较治疗前明显降低,且观察组患者明显低于对照组,差异均有统计学意义(P<0.05)。结论:曲美他嗪联合琥珀酸美托洛尔治疗冠心病心力衰竭能有效降低患者血压,稳定心率,改善患者的心功能。

OBJECTIVE:To probe into the clinical efficacy of trimetazidine combined with metoprolol succinate in treatment of heart failure of coronary heart disease.METHODS:90 patients with heart failure of coronary heart disease admitted into General Hospital of Fushun Mining Bureau from Jan.2015 to Oct.2016 were selected and divided into observation group and control group via random number table,with 45 cases in each group.The control group was treated with metoprolol succinate based on conventional therapy,while the observation group was given trimetazidine based on the control group.Both groups were treated for 12 weeks.Differences in blood pressure,heart rate,left ventricular end diastolic dimension(LVEDD),left ventricular end systolic dimension(LVESD),left ventricular ejection fraction(LVEF)and brain natriuretic peptide(BNP)between two groups before and after treatment were compared.RESULTS:After treatment,the systolic blood pressure,diastolic blood pressure and heart rate of both groups had been significantly decreased,and those of the observation group were significantly lower than the control group,with statistically significant differences(P<0.05);after treatment,the LVEDD and LVESD levels of both groups had been significantly decreased,the LVEF level of both groups had been significantly increased,and those of the observation group were significantly better than the control group,with statistically significant differences(P<0.05);after treatment,the average BNP levels of observation group and control group were respectively(221.62±10.84)pg/ml and(268.25±11.42)pg/ml,both had been significantly decreased,and that of the observation group was significantly lower than the control group,with statistically significant differences(P<0.05).CONCLUSIONS:The combination of trimetazidine and metoprolol succinate in treatment of heart failure of coronary heart disease can effectively reduce blood pressure,stabilize heart rate and improve cadiac function.