摘要
目的:观察奥美沙坦酯联合美托洛尔治疗老年慢性心力衰竭(CHF)患者的效果。方法:选取2021年3月至2022年9月该院收治的114例老年CHF患者进行前瞻性研究,按随机数字表法将其分为对照组与研究组各57例。对照组采用美托洛尔治疗,研究组在对照组基础上联合奥美沙坦酯治疗,比较两组临床疗效、治疗前后心功能指标[左心房内径(LAD)、6 min步行试验距离(6MWT)、左心室射血分数(LVEF)、每搏输出量(SV)]水平、心肌损伤标志物[长正五聚蛋白-3(PTX-3)、心型脂肪酸结合蛋白(H-FABP)、B型脑钠肽(BNP)]水平、炎性因子[白细胞介素-23(IL-23)、肿瘤坏死因子-α(TNF-α)、核苷酸结合寡聚化结构域样受体蛋白3(NLRP3)、C反应蛋白(CRP)]水平和不良反应发生率。结果:研究组治疗总有效率为89.47%(51/57),高于对照组的75.44%(43/57),差异有统计学意义(P<0.05);两组LAD水平均低于治疗前,且研究组低于对照组,两组6MWT、LVEF、SV水平均高于治疗前,且研究组高于对照组,差异有统计学意义(P<0.05);两组PTX-3、BNP、H-FABP水平均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05);两组IL-23、TNF-α、NLRP3、CRP水平均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:奥美沙坦酯联合美托洛尔治疗老年CHF患者可提高治疗总有效率,改善心功能指标水平,降低心肌损伤标志物和炎性因子水平,其效果优于单纯美托洛尔治疗。
Objective:To observe effects of Olmesartan medoxomil combined with Metoprolol in treatment of elderly patients with chronic heart failure(CHF).Methods:A prospective study was conducted on 114 elderly patients with CHF admitted to this hospital from March 2021 to September 2022.According to the random number table method,they were divided into control group and study group,57 cases in each group.The control group was treated with Metoprolol,while the study group was treated with Olmesartan medoxomil on the basis of that of the control group.The clinical efficacy,the cardiac function index levels[left atrial diameter(LAD),6 min walking distance(6 MWT),left ventricular ejection fraction(LVEF),stroke volume(SV)],the myocardial injury marker levels[pentraxin-3(PTX-3),heart-type fatty acid binding protein(H-FABP),B-type brain natriuretic peptide(BNP)],the inflammatory factor levels[interleukin-23(IL-23),tumor necrosis factor-α(TNF-α),nucleotide-binding oligomerization domain-like receptor protein 3(NLRP3),C-reactive protein(CRP)],and the incidence of adverse reactions were compared between the two groups before and after the treatment.Results:The total effective rate of treatment in the study group was 89.47%(51/57),which was higher than 75.44%(43/57)in the control group,and the difference was statistically significant(P<0.05).The LAD levels of the two groups were lower than those before the treatment,and that in the study group was lower than that in the control group;the levels of 6MWT,LVEF and SV in the two groups were higher than those before the treatment,and those in the study group were higher than those in the control group;and the differences were statistically significant(P<0.05).The levels of PTX-3,BNP and H-FABP in the two groups were lower than those before the treatment,and those in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).The levels of IL-23,TNF-α,NLRP3 and CRP in the two groups were lower than those before the treatment,those in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Olmesartan medoxomil combined with Metoprolol in the treatment of the elderly patients with CHF can improve the total effective rate of treatment,improve the levels of cardiac function indexes and reduce the levels of myocardial injury markers and inflammatory factors.Moreover,it is superior to single Metoprolol treatment.
作者
石军伟
张海峰
麻辉
SHI Junwei;ZHANG Haifeng;MA Hui(Pingdingshan Shenma Medical Group General Hospital,1.Pharmaceutic Department,Pingdingshan 467000 Henan,China;Cardiology Department,Pingdingshan 467000 Henan,China)
出处
《中国民康医学》
2023年第23期42-45,共4页
Medical Journal of Chinese People’s Health
关键词
老年
慢性心力衰竭
奥美沙坦酯
美托洛尔
心功能
心肌损伤标志物
炎性因子
Elderly
Chronic heart failure
Olmesartan medoxomil
Metoprolol
Cardiac function
Myocardial injury marker
Inflammatory factor
