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目的探讨厄贝沙坦氢氯噻嗪联合美托洛尔治疗急性重症心力衰竭的效果。方法纳入2013年8月—2015年8月确诊的急性重症心力衰竭患者126例,随机分为对照组与研究组,对照组60例给予常规抗心衰治疗,研究组66例在对照组基础上给予厄贝沙坦氢氯噻嗪与美托洛尔治疗。厄贝沙坦氢氯噻嗪,1片/d;美托洛尔起始剂量控制在12.5~25 mg,2次/d,当患者无不适症状后逐渐增加剂量,但不超过50 mg,1个月为1疗程,连用3个疗程。对比两组治疗疗效与临床指标改善情况。计数资料比较采用χ~2检验,计量资料比较采用t检验,P<0.05为差异有统计学意义。结果研究组总有效率92.4%高于对照组75.0%,比较差异有统计学意义(χ~2=7.15,P<0.01);研究组、对照组治疗后HR值[(70.2±8.9)、(88.6±11.4)次/min]、SBP值[(106.4±11.3)、(128.4±13.9)mm Hg]与DBP值[(65.7±5.2)、(84.3±8.4)mm Hg]均低于治疗前相关数据,LVEF值[(43.9±6.6)、(41.7±4.3)%]高于治疗前相关数据,比较差异有统计学意义(均P<0.05)。结论急性重症心力衰竭患者给予厄贝沙坦氢氯噻嗪联合美托洛尔治疗,疗效显著,可有效降低患者心率、收缩压与舒张压,增加左室射血分数。
Objective To investigate the effect of irbesartan and hydrochlorothiazide combined with metoprolol in the treatment of acute severe heart failure. Methods One hundred and sixty-six patients with acute severe heart failure diagnosed from August 2013 to August 2015 were randomly divided into control group and study group, 60 cases in control group were given routine anti-heart failure treatment, 66 cases in study group were on the basis of control group Give irbesartan hydrochlorothiazide and metoprolol treatment. Irbesartan hydrochlorothiazide, 1 / d; metoprolol initial dose control in 12.5 ~ 25 mg, 2 times / d, when patients without symptoms gradually increase the dose, but not more than 50 mg, 1 month 1 course of treatment, once every 3 courses. Comparison of two groups of treatment efficacy and clinical indicators to improve the situation. Counting data were compared using χ ~ 2 test, measurement data were compared using t test, P <0.05 for the difference was statistically significant. Results The total effective rate was 92.4% in the study group and 75.0% in the control group, with significant difference (χ ~ 2 = 7.15, P <0.01). The HR of the study group and the control group [(70.2 ± 8.9) 88.6 ± 11.4) times / min, SBP values of (106.4 ± 11.3) and (128.4 ± 13.9) mm Hg and DBP values (65.7 ± 5.2 and 84.3 ± 8.4 mmHg) were lower than those before treatment Data, LVEF values [(43.9 ± 6.6), (41.7 ± 4.3)%] were higher than those before treatment, with statistical significance (all P <0.05). Conclusion In patients with acute severe heart failure, irbesartan plus hydrochlorothiazide combined with metoprolol have significant curative effect, which can effectively reduce heart rate, systolic pressure and diastolic pressure and increase left ventricular ejection fraction.