美托洛尔联合厄贝沙坦氢氯噻嗪对老年重症心力衰竭患者B型脑钠肽、左心室射血分数的影响

目的探讨老年重症心力衰竭(简称心衰)患者急诊内科治疗中给予联合使用美托洛尔、厄贝沙坦氢氯噻嗪的效果。方法选取2016年8月至2017年8月首都医科大学宣武医院急诊科收治的重症心衰患者92例,按随机数字法分为研究组与参照组各46例,给予两组患者利尿、强心、抗感染等常规基础治疗,在此基础上再给予参照组患者美托洛尔治疗,再给予研究组患者美托洛尔+厄贝沙坦氢氯噻嗪治疗,观察患者心功能、生活质量改善等情况。结果经治疗3、6个月后,与参照组对比,研究组美国纽约心脏病学会心功能分级、B型脑钠肽水平均显著更低于,左心室射血分数显著更高(P<0.05);治疗后,研究组总有效率(95.65%)比参照组(73.91%)显著更高,不良反应总发生率为4.35%,相比参照组的17.39%显著更低(χ2分别为8.424和4.039,P<0.05);研究组治疗后SF-36量表中4个维度评分均显著高于参照组(P<0.05)。结论在常规急诊内科治疗基础上再给予重症心衰患者美托洛尔、厄贝沙坦氢氯噻嗪治疗,可使患者心功能获得更大程度改善,缓解其心衰症状,提高治疗总体治疗效果,且可减少不良反应,有助于患者生活质量获得显著改善。

Effect of metoprolol combined with irbesartan hydrochlorothiazide on BNP and LVEF in elderly patients with severe heart failure

Objective To evaluate the effect of metoprolol and irbesartan hydrochlorothiazide in the treatment of senile patients with severe heart failure.Method From August 2016 to August 2017,92 patients with severe heart failure were randomly divided into two groups,each group had 46 cases,the patients in the two groups were given routine basic treatment such as diuresis,cardiotonic therapy and anti-infection,on this basis,metoprolol was given to the control group,metoprolol plus irbesartan hydrochlorothiazide was given to the study group.the heart function and quality of life of the patients were observed.Result After 3 or 6 months’treatment,compared with the reference group,the NYHA grade and BNP level in the study group were significantly lower than those in the study group,and LVEF was significantly higher(P<0.05);After treatment,the total effective rate of the study group was 95.65%,which was significantly higher than that of the control group(73.91%).The total incidence of adverse reactions was 4.35%,which was significantly lower than that of the control group(17.39%)(χ2=8.424、4.039,P<0.05);The 4 dimensions of the SF-36 scale in the study group were significantly higher than those in the reference group(P<0.05).Conclusion On the basis of routine emergency medical treatment,metoprolol and irbesartan hydrochlorothiazide were given to patients with severe heart failure,can improve the heart function,relieve the symptoms of heart failure,improve the overall treatment effect,and reduce adverse reactions,which is conducive to significantly improve the quality of life of patients.