2020 年第 4 期 第 15 卷

美托洛尔联合曲美他嗪治疗慢性心力衰竭患者的临床效果

Effect of metoprolol combined with trimetazidine on chronic heart failure

作者：胡晴王永曹红涛周晓映高江彦刘超

英文作者：Hu Qing Wang Yong Cao Hongtao Zhou Xiaoying Gao Jiangyan Liu Chao

单位：河北省胸科医院心内科，石家庄050041

英文单位：Department  of  Cardiology Hebei  Chest  Hospital Shijiazhuang 050041 China

关键词：慢性心力衰竭；美托洛尔；曲美他嗪；心肌功能

英文关键词：Chronicheartfailure;Metoprolol;Trimetazidine;Myocardialfunction

• 摘要：

• 【摘要】目的    探讨美托洛尔联合曲美他嗪对慢性心力衰竭患者心肌重塑及血清N末端B型脑钠肽前体（NT-proBNP）、高敏C反应蛋白（hs-CRP）水平的影响。方法    选取2016年12月至2018年12月河北省胸科医院收治的慢性心力衰竭患者100例，完全随机分为观察组和对照组，各50例。对照组在常规治疗基础上联合口服酒石酸美托洛尔片治疗，观察组在对照组基础上联合口服盐酸曲美他嗪片治疗。观察2组临床疗效、血清NT-proBNP、hs-CRP水平、心肌重塑情况、生活质量和不良反应发生情况。结果    观察组总有效率高于对照组［92.0%（46/50）比76.0%（38/50）］，差异有统计学意义（χ2=4.714，P=0.030）。治疗后2组NT-proBNP、hs-CRP水平、左心室收缩末期内径和左心室舒张末期内径、生活质量评分均明显低于治疗前，且观察组低于对照组［（458±80）ng/L比（873±110）ng/L、（10.5±2.9）mg/L比（14.4±3.6）mg/L、（36±4）mm比（41±4）mm、（49±4）mm比（56±4）mm、（41±5）分比（49±6）分］；左心室射血分数明显高于治疗前，且观察组高于对照组［（53±5）%比（47±5）%］，差异均有统计学意义（均P＜0.05）。2组不良反应发生率差异无统计学意义（χ2=0.121，P=0.728）。结论    美托洛尔联合曲美他嗪治疗慢性心力衰竭能有效降低血清NT-proBNP、hs-CRP水平，促进心肌重塑，提高临床疗效，改善生活质量，且安全性较高。

• 【Abstract】Objective    To explore the effect of metoprolol combined with trimetazidine on myocardial remodeling, serum levels of N-terminal pro-brain natriuretic peptid(NT-proBNP) and hypersensitive C-reactive protein(hs-CRP) in patients with chronic heart failure. Methods    A total of 100 patients with chronic heart failure admitted to Hebei Chest Hospital from December 2016 to December 2018 were randomly divided into observation group and control group, with 50 cases in each group. The control group took metoprolol and the observation group took metoprolol plus trimetazidine on the basis of routine treatment. Clinical efficacy, serum NT-proBNP and hs-CRP levels, myocardial remodeling, quality of life and adverse reactions were analyzed. Results    Total clinical effective rate in observation group was significantly higher than that in control group［92.0%（46/50） vs 76.0%（38/50）］（χ2=4.714, P=0.030）. After treatment, levels of serum NT-proBNP and hs-CRP, left ventricular end-systolic dimension, left ventricular end-diastolic dimension, quality of life score significantly decreased compared with those before treatment; the indexes in observation group were significantly lower than those in control group［（458±80）ng/L vs （873±110）ng/L, （10.5±2.9）mg/L vs （14.4±3.6）mg/L, （36±4）mm vs （41±4）mm, （49±4）mm vs （56±4）mm, （41±5） vs （49±6）］; left ventricular ejection fraction significantly increased after treatment and it was higher in observation group than that in control group［（53±5）% vs （47±5）%］(all P<0.05). There was no significant difference in the incidence of adverse reactions between groups(χ2=0.121, P=0.728). Conclusion    Metoprolol combined with trimetazidine treating chronic heart failure can effectively reduce serum NT-proBNP and hs-CRP, promote myocardial remodeling and improve quality of life; the adverse reactions are tolerable.