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目的探究美托洛尔联合曲美他嗪对冠状动脉粥样硬化性心脏病(冠心病)心力衰竭(心衰)患者血浆脑尿钠肽(brain natriuretic peptide,BNP)水平及心功能的影响。方法选择2016年1—12月本院收治的冠心病心衰患者90例作为研究对象,随机分为对照组和观察组各45例。对照组给予常规治疗,观察组应用美托洛尔联合曲美他嗪治疗,对比两组治疗前后血浆BNP水平及心功能指标。计量资料组间比较采用t检验,组内比较采用配对t检验,计数资料采用χ2检验,P<0.05为差异有统计学意义。结果观察组总有效率为95.56%,高于对照组的71.11%,差异有统计学意义(P<0.05)。治疗后,观察组与对照组血浆BNP、心率(heart rate,HR)、左心室射血分数(left ventricular ejection fraction,LVEF)水平分别为(227.04±11.45)pg/ml、(75.78±9.25)次/min、(51.01±7.57)%、(265.13±12.05)pg/ml、(84.54±11.78)次/min、(45.76±58.35)%,均优于治疗前的(294.87±12.57)pg/ml、(93.01±12.37)次/min、(42.67±6.34)%、(295.37±12.45)pg/ml、(93.23±12.5)次/min、(41.34±6.35)%,差异均有统计学意义(均P<0.05)。治疗后,观察组各指标均优于对照组,差异均有统计学意义(均P<0.05)。结论在临床中,对于冠心病心衰患者实施美托洛尔联合曲美他嗪治疗效果明显,具备推广及应用的可行性及价值。
Objective To investigate the effect of metoprolol combined with trimetazidine on plasma brain natriuretic peptide (BNP) level and cardiac function in patients with coronary heart disease (CHF) complicated with heart failure (CHF). Methods Ninety patients with coronary heart disease who were admitted to our hospital from January to December in 2016 were randomly divided into control group and observation group of 45 cases. The control group was given routine treatment. The observation group was treated with metoprolol combined with trimetazidine. The plasma BNP levels and cardiac function were compared between the two groups before and after treatment. Measurement data were compared between groups using t test, the group was compared using paired t test, count data using χ2 test, P <0.05 for the difference was statistically significant. Results The total effective rate in observation group was 95.56%, which was higher than that in control group (71.11%), the difference was statistically significant (P <0.05). After treatment, the levels of plasma BNP, heart rate (HR) and left ventricular ejection fraction (LVEF) in observation group and control group were (227.04 ± 11.45) pg / ml and (75.78 ± 9.25) times (51.01 ± 7.57)%, (265.0 ± 12.05) pg / ml, (84.54 ± 11.78) times / min and (45.76 ± 58.35)%, respectively, which were all better than those before treatment (294.87 ± 12.57) pg / (93.01 ± 12.37) times / min, (42.67 ± 6.34)%, (295.37 ± 12.45) pg / ml, (93.23 ± 12.5) times / min, (41.34 ± 6.35)%, the differences were statistically significant <0.05). After treatment, the indicators of the observation group were better than the control group, the differences were statistically significant (P <0.05). Conclusion In clinical practice, metoprolol combined with trimetazidine is effective in patients with heart failure due to coronary heart disease, which has the feasibility and value of popularization and application.