单硝酸异山梨酯片单用和联合曲美他嗪片治疗慢性心力衰竭的疗效比较

目的 探讨单独应用单硝酸异山梨酯片和单硝酸异山梨酯片联合曲美他嗪片治疗慢性心力衰竭患者疗效。方法选取酒泉市人民医院收治的138例慢性心力衰竭患者作为研究对象，采用双盲法将其分为对照组和观察组，各69例。对照组给予单硝酸异山梨酯片治疗，观察组在此基础上增加曲美他嗪片治疗，两组均连续治疗6个月。治疗6个月后，比较两组临床疗效、心功能、炎症指标、血清组织蛋白酶S(Cat S)、血小板反应蛋白-1(TSP-1)、脑钠肽(BNP)水平，并观察两组不良反应发生情况。结果 观察组临床总有效率(91.30%)高于对照组(81.16%)，差异有统计学意义(P<0.05)。观察组心功能指标、炎性细胞因子指标、Cat S、TSP-1及BNP水平治疗前后差值高于对照组(P<0.05)。两组总不良反应发生率比较，差异无统计学意义(χ²=0.122,P=0.727)。结论 单硝酸异山梨酯片联合曲美他嗪片可有效改善慢性心力衰竭患者心功能，减轻其炎症反应，改善血清Cat S、TSP-1及BNP水平，疗效确切，且安全性较高。

Comparative study on the efficacy of isosorbide mononitrate tablets alone and isosorbide mononitrate tablets combined with trimetazidine tablets in the treatment of patients with chronic heart failure

Objective To investigate the efficacy of isosorbide mononitrate tablets and isosorbide mononitrate tablets combined with trimetazidine tablets in the treatment of chronic heart failure. Methods A total of 138 patients with chronic heart failure in our hospital were selected and divided into the control group and the observation group by double-blind method with 69 cases each. The control group was treated with isosorbide mononitrate tablets, while the observation group was treated with trimetazidine tablets, and both groups were treated continuously for six months. After six months of treatment, the clinical efficacy, cardiac function, inflammatory index, serum cathepsin S, platelet reactive protein-1, and brain natriuretic peptide levels of the two groups were compared, and the occurrence of adverse reactions was observed.Results The total clinical effective rate of the observation group(91.30%) was higher than that of the control group(81.16%), and the difference was statistically significant(P<0.05).The variations of cardiac function indicators, inflammatory cytokine indicators, Cat S, TSP-1, and BNP levels before and after treatment in the observation group was more obvious than that of the control group(P<0.05). There was no significant difference in the total incidence of adverse reactions between the two groups(χ²=0.122, P=0.727). Conclusions Isosorbide mononitrate capsule combined with trimetazidine tablets can effectively improve cardiac function, reduce inflammatory reaction and improve the levels of serum Cat s, TSP-1 and BNP in patients with chronic heart failure. It has definite curative effect and high safety.