美托洛尔与曲美他嗪联合治疗老年冠心病心力衰竭对患者心功能和炎症因子的影响

赵智慧 潘云红

[摘要] 目的 探討美托洛尔与曲美他嗪联合治疗老年冠心病心力衰竭对患者心功能和炎症因子的影响。 方法 在2018年5月至2020年5月期间，随机纳入我院66例老年冠心病心力衰竭患者作为观察对象，将其分为对照组和观察组，每组33例。对照组使用美托洛尔治疗，观察组在此基础上加用曲美他嗪。对比两组患者治疗前后的心功能、炎症因子水平。 结果 两组治疗前的IL-6、IL-10及CRP水平比较，差异无统计学意义（P>0.05），两组在治疗后的IL-6、IL-10及CRP水平比较差异均有统计学意义（P<0.05）;两组治疗前心功能LVEF值、LVEDd值及6 min步行距离值对比差异无统计学意义（P>0.05），两组治疗后心功能LVEF值、LVEDd值及6 min步行距离值对比差异有统计学意义（P<0.05）。治疗后，观察组患者的身体状况明显更优，各评分也优于对照组，组间差异有统计学意义（P<0.05）。 结论 对老年冠心病心力衰竭患者结合使用美托洛尔与曲美他嗪联合治疗的效果较好，不仅可以及时改善患者的心功能、减轻体征，缓解症状，还能有效降低体内炎症因子水平的表达，临床价值较高。

[关键词] 美托洛尔;曲美他嗪;老年冠心病;心力衰竭;心功能

[Abstract] Objective To investigate the impacts of metoprolol combined with trimetazidine on cardiac function and inflammatory factors in elderly patients with coronary heart disease and cardiac failure. Methods A total of 66 cases of elderly patients with coronary heart disease and cardiac failure admitted to our hospital from May 2018 to May 2020 were randomly selected as the observation objects， and they were divided into the control group（n=33） and the observation group（n=33）. The control group was treated with metoprolol， while the observation group was additionally treated with trimetazidine. The levels of cardiac function and inflammatory factors were compared between the two groups of patients before and after treatment. Results There was no significant difference in the levels of IL-6， IL-10 and CRP between the two groups before treatment（P>0.05）， but there were significant differences in the levels of IL-6， IL-10 and CRP between the two groups after treatment（P<0.05）. There was no significant difference in LVEF， LVEDd and 6-minute walking distance between the two groups before treatment（P>0.05）， but there were statistically significant differences in LVEF， LVEDd and 6-minute walking distance between the two groups after treatment（P<0.05）. After treatment， the physical condition of patients in the observation group was obviously better， and the scores were also superior to those in the control group， with significant differences between the groups（P<0.05）. Conclusion The combination of metoprolol and trimetazidine is effective in elderly patients with coronary heart disease and cardiac failure， which can not only improve the cardiac function， relieve the signs and symptoms in time， but also effectively reduce the expressions of inflammatory factors in the body， and has relatively higher clinical value.

[Key words] Metoprolol; Trimetazidine; Elderly patients with coronary heart disease; Cardiac failure; Cardiac function

冠心病是中老年群体中发生率非常高的慢性疾病，在冠心病群体中，有超过一半的患者容易出现慢性心力衰竭[1]。冠心病的主要病理改变是冠状动脉粥样硬化，引起冠状动脉狭窄或闭塞，导致心肌供血不足，心肌缺血缺氧，心肌能量代谢障碍，从而出现心绞痛、心肌梗死[2]。因其心肌损害，致心脏收縮舒张功能减弱，故冠心病最易出现慢性心力衰竭[3]。关于老年冠心病心力衰竭患者的治疗也受到心内科医师的广泛关注，其治疗以改善心肌血供，减少心脏做功从而减轻心衰临床表现。美托洛尔可对体内的β1受体产生一定的抑制作用，特别对心脏β1受体活性具有高选择性阻断，从而用于减慢心率、抑制心收缩力、降低自律性和延缓房室传导时间、延长心肌应期，减少心脏做功，纠正心力衰竭。曲美……