摘要
目的观察倍他乐克联合贝那普利治疗老年慢性稳定性心力衰竭(CHF)的临床疗效,并探讨其对患者心室重塑的影响。方法选择2018年1月至2020年1月在西安市北方医院就诊的老年CHF患者80例,按随机数表法分为观察组和对照组各40例,对照组给予贝那普利治疗,观察组在对照组治疗的基础上联合倍他乐克治疗,两组均治疗6个月。比较两组患者治疗6个月后的治疗效果,治疗前后的心室重塑指标、心功能指标以及治疗后6 min步行距离和不良反应发生情况。结果治疗结束后,观察组患者的治疗有效率为87.50%,明显高于对照组的67.50%,差异有统计学意义(P<0.05);治疗6个月后,观察组患者的左室后壁厚度(LVPWT)、舒张末期室间隔厚度(IVST)、左室收缩末期内径(LVESD)、左室舒张末期内径(LVEDD)水平分别为(8.09±0.37)mm、(8.13±0.56)mm、(50.72±9.34)mm、(45.34±4.22)mm,明显低于对照组的(8.68±0.32)mm、(8.79±0.88)mm、(56.86±9.36)mm、(49.45±4.30)mm,差异均有统计学意义(P<0.05);治疗6个月后,观察组患者的左室心肌重量指数(LVMI)、左室射血分数(LVEF)水平分别为(107.81±4.17)g/m^(2)、(50.56±4.34)%,明显高于对照组的(103.57±3.18)g/m^(2)、(46.77±5.64)%,差异均有统计学意义(P<0.05);治疗6个月后,观察组患者的6 min步行距离为(408.56±21.36)m,明显长于对照组的(388.84±23.68)m,血清脑钠肽(BNP)、内皮素-1(ET-1)水平为(834.25±137.52)μg/L、(82.67±9.33)ng/L,明显低于对照组的(901.25±146.58)μg/L、(88.64±10.08)ng/L,差异均有统计学意义(P<0.05);两组患者治疗期间的不良反应发生率比较差异无统计学意义(P>0.05)。结论倍他乐克联合贝那普可改善老年CHF患者心室重塑,同时改善患者的心功能指标和血管内皮功能,安全性较高。
Objective To observe the clinical curative effect of betaloc combined with benazepril in the treatment of chronic stable heart failure(CHF)for elderly patients and its effect on ventricular remodeling.Methods A total of 80 elderly CHF patients who were treated in Xi’an North Hospital from January 2018 to January 2020 were enrolled.They were divided into observation group and control group by random number table method,with 40 patients in each group.The control group was treated with benazepril,and the observation group was treated with betaloc on the basis of the control group.Both groups were treated for 6 months.The curative effect after 6 months of treatment,ventricular remodeling and cardiac function indexes before and after treatment,6 minutes walking distance(6 MWD),and occurrence of adverse reactions after treatment were compared between the two groups.Results After treatment,response rate of treatment in observation group was significantly higher than control group(87.50%vs 67.50%),P<0.05.After 6 months of treatment,the levels of left ventricular posterior wall thickness(LVPWT),diastolic ventricular septal thickness(IVST),left ventricular end systolic diameter(LVESD)and left ventricular end diastolic diameter(LVEDD)in the observation group were(8.09±0.37)mm,(8.13±0.56)mm,(50.72±9.34)mm,and(45.34±4.22)mm,which were significantly lower than(8.68±0.32)mm,(8.79±0.88)mm,(56.86±9.36)mm,(49.45±4.30)mm in control group,P<0.05.After6 months of treatment,levels of left ventricular mass index(LVMI)and left ventricular ejection fraction(LVEF)in the observation group were(107.81±4.17)g/m^(2) and(50.56±4.34)%,which were significantly higher than(103.57±3.18)g/m^(2),(46.77±5.64)%in the control group,P<0.05.After 6 months of treatment,6 MWD in the observation group was significantly longer than in control group(408.56±21.36)m vs(388.84±23.68)m,while levels of serum brain natriuretic peptide(BNP)and endothelin-1(ET-1)were(834.25±137.52)μg/L and(82.67±9.33)ng/L,which were significantly lower than[(901.25±146.58)μg/L,(88.64±10.08)ng/L in control group(P<0.05).There was no significant difference in the incidence of adverse reactions during treatment between the two groups(P>0.05).Conclusion Betaloc combined with benazepril can improve ventricular remodeling,cardiac function indexes and vascular endothelial function in the elderly with CHF,with high safety.
作者
袁森
闫洁
YUAN Sen;YAN Jie(Department-of Cardiology,Xi'an,North Hospital,Xi'an 710043,Shaanxi,CHINA;Department-of Geriatrics,Xi'an,North Hospital,Xi'an 710043,Shaanxi,CHINA)
出处
《海南医学》
CAS
2021年第5期563-566,共4页
Hainan Medical Journal
关键词
心力衰竭
倍他乐克
贝那普利
老年
心室重塑
心功能
Heart failure
Betaloc
Benazepril
Elderly
Ventricular remodeling
Cardiac function
