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目的探讨美托洛尔联合曲美他嗪治疗冠心病心力衰竭的疗效及安全性。方法选择冠心病心力衰竭患者200例,随机分为对照组与观察组,每组100例,两组患者入组后予强心利尿、扩冠及控制血压等常规治疗,观察组在常规治疗基础上给予曲美他嗪联合美托洛尔联合治疗,比较两组治疗后的临床疗效、6 min内最大步行距离、左室射血分数(LVEF)、左心室收缩末期内径(LVESD)和左心室舒张末期内径(LVEDD)。结果观察组总有效率为91.0%,明显高于对照组74.0%,两组比较差异有统计学意义(P<0.05);观察组治疗后6 min最大步行距离[(302.6±26.7)m]比治疗前[(144.5±11.2)m]显著提高(t=39.752,P<0.01),对照组治疗后[(268.5±22.6)m]与治疗前[(140.6±10.8)m]比较亦有提高(t=37.173,P<0.01)。观察组患者最大步行距离远于对照组,差异有统计学意义(P<0.01);LVESD、LVEDD显著低于对照组,差异有统计学意义(P均<0.01)。结论美托洛尔联合曲美他嗪可显著改善冠心病心力衰竭患者心功能,提高临床疗效。
Objective To investigate the efficacy and safety of metoprolol combined with trimetazidine in the treatment of heart failure with coronary heart disease. Methods 200 cases of heart failure patients with coronary heart disease were randomly divided into control group and observation group, with 100 cases in each group. Patients in both groups were given conventional therapy such as cardiac diuresis, crown expansion and blood pressure control. Were given trimetazidine combined metoprolol treatment, the clinical efficacy of the two groups were compared, the maximum walking distance within 6 min, left ventricular ejection fraction (LVEF), left ventricular end-systolic diameter (LVESD) and left ventricular End-diastolic diameter (LVEDD). Results The total effective rate in the observation group was 91.0%, which was significantly higher than that in the control group (74.0%), the difference was statistically significant (P <0.05). The maximum walking distance at 6 min after the observation group [(302.6 ± 26.7) m] Before treatment (144.5 ± 11.2) m was significantly higher than that before treatment (t = 39.752, P <0.01), while the control group (268.5 ± 22.6 m) was also improved compared with that before treatment [(140.6 ± 10.8) m] t = 37.173, P <0.01). The maximum walking distance in the observation group was significantly longer than that in the control group (P <0.01). LVESD and LVEDD in the observation group were significantly lower than those in the control group (P <0.01). Conclusion Metoprolol combined with trimetazidine can significantly improve heart function in patients with heart failure and improve clinical efficacy.