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目的观察厄贝沙坦氢氯噻嗪早期联合美托洛尔治疗老年重症心力衰竭的疗效。方法将130例年龄70.5±5.9岁,NYHA 心功能分级的重症充血性心力衰竭(CHF)患者分为3组,即厄贝沙坦氢氯噻嗪联合美托洛尔治疗组(44例),厄贝沙坦氢氯噻嗪治疗组(46例)和对照组(40例),随访1年,以 NYHA 心功能分级,超声心动图所示左室射血分数(LVEF)年住院次数,年住院日和死亡例数来评估治疗效果,并探讨 B 型利钠肽(BNP)在心力衰竭处理中的价值。结果 0.5年时联合治疗组与厄贝沙坦氢氯噻嗪组间 BNP 存在统计学意义(P<0.05)。心功能分级、LVEF 无统计学意义;而联合治疗组及厄贝沙坦氢氯噻嗪组的心功能分级、LVFF、BNP 与对照组存在统计学意义(P<0.05或 P<0.01)。1年时联合治疗组与厄贝沙坦氢氯噻嚎组的心功能分级、LVEF、BNP 存在统计学意义(P<0.05或P<0.01);而厄贝沙坦氢氯噻嗪组和联合治疗组的心功能分级、BNP、LVEF 与对照组存在统计学意义(P<0.01)。联合治疗组年住院次数及住院日、死亡数最少。结论早期厄贝沙坦氢氯噻嗪联合美托洛尔治疗老年重症 CHF 比单用厄贝沙坦氢氯噻嗪有更好的临床疗效,其疗效在0.5年后出现,且能很好地提高患者生活质量。
Objective To observe the efficacy of irbesartan and hydrochlorothiazide combined with metoprolol in the treatment of elderly patients with severe heart failure. Methods One hundred and thirty patients (70.5 ± 5.9 years old, NYHA functional class) with severe congestive heart failure (CHF) were divided into three groups: Erbesartan hydrochlorothiazide combined metoprolol group (44 cases) (N = 46) and control group (n = 40). The patients were followed up for 1 year. The NYHA functional class, echocardiographic left ventricular ejection fraction (LVEF) hospital year, hospital stay and death cases To assess the therapeutic effect, and to explore the value of B-type natriuretic peptide (BNP) in the treatment of heart failure. Results At 0.5 year, there was a significant difference in BNP between the combination therapy group and the irbesartan hydrochlorothiazide group (P <0.05). Heart function grading, LVEF was not statistically significant; while the combination therapy group and irbesartan hydrochlorothiazide group of cardiac function classification, LVFF, BNP and the control group there was a statistically significant (P <0.05 or P <0.01). At 1 year, the cardiac function classification, LVEF and BNP in the combination therapy group and irbesartan hydrochlorothiazole group were statistically significant (P <0.05 or P <0.01); while the irbesartan hydrochlorothiazide group and the combination therapy group Cardiac function classification, BNP, LVEF and the control group there was a statistically significant (P <0.01). Combined treatment group annual hospitalization and hospitalization days, the least number of deaths. Conclusion Early treatment with irbesartan and metoprolol combined with metoprolol in senile patients with severe CHF has better clinical efficacy than irbesartan hydrochloride alone. The efficacy of irbesartan in combination with metoprolol appears after 0.5 years and can improve the quality of life of patients.