曲美他嗪聯合美托洛爾治療冠心病心力衰竭患者中的應用

平兆幸

[關鍵詞] 冠心病;心力衰竭;曲美他嗪;美托洛爾;心功能;生命體征

[中圖分類號] R541.4? ? ? ? ? [文獻標識碼] B? ? ? ? ? [文章編號] 1673-9701（2021）20-0051-03

Application of trimetazidine combined with metoprolol in the treatment of patients with coronary heart disease and heart failure

PING Zhaoxing

Department of Cardiovascular Medicine，Pingxiang No.2 People′s Hospital，Pingxiang? ?337000，China

[Abstract] Objective To investigate the clinical efficacy of trimetazidine combined with metoprolol in the treatment of coronary heart disease （CHD） and heart failure （HF），and to provide a reference for the clinical medication. Methods The clinical data of 80 patients with CHD and HF admitted to our hospital from October 2017 to November 2019 were analyzed retrospectively. 40 patients treated with metoprolol alone were included in the control group，and 40 patients treated with metoprolol and trimetazidine were included in the observation group. The changes in the levels of cardiac function [left ventricular end-systolic diameter （LVESD），left ventricular end-diastolic dimension （LEVDD）] and vital signs [diastolic blood pressure （DBP），systolic blood pressure （SBP），heart rate （HR）] before and after treatment were compared between the two groups. Results Before treatment，the levels of LVEDD，LVESD，LVEF，SBP，DBP and HR in the observation group were not significantly different from those in the control group （P>0.05）.Three months after treatment，the levels of LVESD and LEVDD were lower in the observation group [（53.24±2.47） mm，（34.15±2.25） mm] than those in the control group [（58.69±3.45） mm，（39.86±2.64） mm]，LVEF level was higher in the observation group [（49.96±3.36）%] than that in the control group [（44.16±3.15）%]，with statistically significant differences（t= 8.124，10.411，7.965，P<0.001）.The levels of DBP，SBP and HR were lower in the observation group [（114.37±11.16） mmHg，（75.98±7.64） mmHg，（83.54±8.78） beats/min] than those in the control group [（134.87±13.51） mmHg，（89.63±8.69） mmHg，（91.18±10.44） beats/min]，with statistically significant differences （t=7.399，7.457，3.542，P=0.000，0.000，0.001）. Conclusion Trimetazidine and metoprolol are helpful to promote the recovery of patients with CHD and HF.

[Key words] Coronary heart disease;Heart failure;Trimetazidine;Metoprolol;Cardiac function;Vital signs

冠心病為臨床中發病率較高的一種疾病，多發群體為老年人，主要因冠狀動脈堵塞或狹窄所致，主要臨床癥狀為胸痛、出汗、呼吸困難等，且活動后加重，若未得到及時治療，將嚴重威脅患者生命健康[1]。另外，冠心病極易引發多種并發癥發生，以心力衰竭較為常見，主要因冠心病導致心臟血流量減少，導致心功能受損，已成為冠心病病死的主要因素[2-3]。目前，藥物為臨床治療冠心病心力衰竭的主要手段，曲美他嗪與美托洛爾均為臨床治療該疾病的主要藥物，前者具有改善微循環作用，可起到有效保護心肌細胞的作用，后者具有顯著的抗心力衰竭作用，故臨床常將兩種藥物聯合應用[4-5]。基于此，本研究旨在分析曲美他嗪與美托洛爾聯合應用于該疾病的治療效果，為臨床用藥提供指導。