摘要
目的探讨美托洛尔联合曲美他嗪对慢性心力衰竭(CHF)患者血清血管紧张素Ⅱ(AngⅡ)、血管内皮功能的影响。方法将136例CHF患者随机分为对照组和试验组,每组68例。对照组给予基础治疗措施和美托洛尔,试验组在对照组基础上加用曲美他嗪。比较2组治疗前后的左心室射血分数(LVEF)、左室舒张末期内径(LVEDd)、左室收缩末期内径(LVESD)、N末端-脑钠肽前体(NT-ProBNP)、6 min步行距离、AngⅡ水平、肱动脉内皮依赖性血管舒张功能(FMD)、血浆一氧化氮(NO)水平、内皮素-1(ET-1)水平、临床疗效及不良反应。结果2组均有2例患者中途退出研究。治疗后,试验组LVEDd、LVESD、NT-ProBNP水平低于对照组,LVEF、6 min步行距离高于对照组,差异均有统计学意义(P<0.05)。治疗后,试验组AngⅡ、ET-1水平均低于对照组,FMD、NO水平高于对照组,差异均有统计学意义(P<0.05)。试验组总有效率为95.45%,高于对照组的84.85%,差异有统计学意义(P<0.05)。试验组不良反应发生率为10.61%,对照组为6.06%,差异无统计学意义(P>0.05)。结论美托洛尔联合曲美他嗪治疗CHF患者安全、有效,可改善患者的心功能、血管内皮功能,提高治疗效果。
Objective To explore the effect of metoprolol combined with trimetazidine on serum angiotensinⅡ(AngⅡ)and vascular endothelial function in patients with chronic heart failure(CHF).Methods Totally 136 CHF patients were randomly divided into control group and experimental group,with 68 cases in each group.The control group was given basic therapeutic measures and metoprolol,while the experimental group was given trimetazidine on the basis of the control group.Left ventricular ejection fraction(LVEF),left ventricular end diastolic diameter(LVEDd),left ventricular end systolic diameter(LVESD),N-terminal pro-B type natriuretic peptide(NT-ProBNP),6-minute walking distance,the level of AngⅡ,endothelial flow-mediated dilation(FMD)of brachial artery,the levels of plasma nitric oxide(NO)and endothelin-1(ET-1),clinical efficacy and adverse reactions were compared between the two groups before and after treatment.Results Two cases in both groups dropped out of the study.After treatment,LVEDd,LVESD and NT-ProBNP level of the experimental group were significantly lower than those of the control group,while the LVEF and 6-minute walking distance were significantly higher than those of the control group(P<0.05).After treatment,AngⅡand ET-1 levels in the experimental group were significantly lower than those in the control group,while FMD and NO levels were significantly higher than those in the control group(P<0.05).The total effective rate of the experimental group was 95.45%,which was significantly higher than 84.85%of the control group(P<0.05).The incidence of adverse reactions was 10.61%in the experimental group,which showed no significant difference when compared to 6.06%in the control group(P>0.05).Conclusion Metoprolol combined with trimetazidine is safe and effective in the treatment of CHF patients,which can improve the heart function and vascular endothelial function and enhance the therapeutic effect.
作者
邱清艳
戴闽
牟英
庾辉
QIU Qingyan;DAI Min;MOU Ying;YU Hui(Department of Cardiovascular Medicine,Mianyang City Central Hospital in Sichuan Province,Mianyang,Sichuan,621000)
出处
《实用临床医药杂志》
CAS
2021年第3期99-102,106,共5页
Journal of Clinical Medicine in Practice
基金
四川省卫生厅科研基金资助项目(100320)。
关键词
美托洛尔
曲美他嗪
慢性心力衰竭
内皮功能
左心室射血分数
metoprolol
trimetazidine
chronic heart failure
endothelial function
left ventricular ejection fraction
