缬沙坦联合美托洛尔治疗老年心力衰竭的疗效及脑钠肽的变化

目的观察缬沙坦联合美托洛尔治疗老年慢性心力衰竭的疗效及脑钠肽的变化。方法132例年龄60～77（平均68）岁、心功能分级Ⅱ、Ⅲ级老年慢性心力衰竭患者完全随机分为2组，对照组予以常规强心（地高辛0．125—0．25mg／d）、利尿（螺内酯20mg／d、间断加用呋塞米10～60mg／d）、硝酸酯类药物（单硝酸异山梨酯20—40mg，2次／d）。治疗组在对照组基础上加用缬沙坦20—160mg，2次／d；美托洛尔6．25—50mg，2次／d，随访180d，检测治疗前后血清脑钠肽的水平，以超声心动图所示左心室射血分数、左心室舒张末期内径、评估心力衰竭治疗效果。结果治疗组66例，显效42例（63．6%），有效19例（29．5％），总有效61例（93．2％）。对照组66例，显效27例（40．9％），有效17例（25．0％），总有效44例（65．9％）。180d时治疗组由的（8．80±4．99）ng／L降低到（6．39±4．01）ng／L，对照组的脑钠肽由治疗前的（8．33±4．16）ng／L降低到治疗后的（7．60±3．86）ng／L，2组治疗前后及2组间差异均存在统计学意义（P〈0．05或P〈0．01）。结论缬沙坦联合美托洛尔治疗老年慢性心力衰竭有较好的临床疗效。

Effect of Valsartan combined with Metoprolol on aged chronic heart failure

Objective To investigate the therapeutic effect of valsartsn combined with metoprolol in geron-tic patient with chronic heart failure (CHF). Methods One hundred and thirty-two cases of CHF Ⅱ and Ⅲ grade with NYHA heart function grade were divided into two groups. Control group (n=66) had digoxin 0.125-0.25 mg/d, spironolactone 20 mg/d plus discontinuously furosemide 10-60 mg/d, isosorbide momomitrate 20-40 mg/d, treatment group (n=66)were given valsartan 20-160 mg and metoprolol 6.25-50 mg twice a day on the basis of the same routine therapy as control group. All patients were followed up for 180 days. Heart function, left ventricular ejection fraction (LVEF), left ventricular end diastolic diameter (LVED) were investigated. Results After 180 days, Brain natriuretic peptid (BNP) in combination group decreased from (8.80±4.99)ng/L to (6.39±4.01) ng/L, BNP in control group decreased from (8.33±4.16) ng/L to (7.60±3.86) ng/L (P<0.05 or P<0.01). Conclusion Valsartan and metoprolol combination therapy shows optimistic therapeutic effect on patientswith chronic heart failure.