氯沙坦早期联合美托洛尔治疗高龄重症心力衰竭的疗效

发布时间：2018-03-26 01:12

本文选题：重症心力衰竭　切入点：高龄患者　出处：《现代生物医学进展》2014年30期

【摘要】：目的:研究氯沙坦早期联合美托洛尔治疗高龄重症心力衰竭的临床疗效。方法:选取2010年1月至2013年1月本院住院治疗的60例高龄重症心力衰竭患者,采用随机数字表法随机分为氯沙坦联合美托洛尔治疗组、氯沙坦治疗组和对照组,每组患者20例;所有患者均采取常规治疗,对照组加用口服强心剂和利尿剂,氯沙坦治疗组在常规治疗的基础上加用氯沙坦,氯沙坦联合美托洛尔治疗组在常规治疗的基础上加用氯沙坦和美托洛尔,在治疗前及治疗后0.5a、1.0a检测所有患者的心功能、左室射血分数(LVEF)和血液中的B型脑钠肽(BNP),并观察治疗后1.0a的临床疗效。结果:治疗前三组患者的心功能、左室射血分数(LVEF)以及B型脑钠肽(BNP)间均无统计学差异(P0.05);氯沙坦治疗组、氯沙坦联合美托洛尔治疗组治疗后0.5a和1.0a的心功能和BNP均低于对照组(P0.05),而治疗后0.5a和1.0a的LVEF均高于对照组(P0.05);氯沙坦联合美托洛尔治疗组治疗后0.5a的心功能、LVEF以及BNP与氯沙坦治疗组无统计学差异(P0.05),而氯沙坦联合美托洛尔治疗组治疗后1.0a的心功能、LVEF以及BNP与氯沙坦治疗组均存在着统计学差异(P0.05);三组治疗后1.0a死亡率间存在统计学差异(P0.05);每年住院次数和平均住院日最少的是氯沙坦联合美托洛尔治疗组,其次为氯沙坦组。结论:氯沙坦与美托洛尔早期联合治疗高龄重症心力衰竭的疗效优于氯沙坦单独治疗。
[Abstract]:Objective: to study the clinical efficacy of losartan combined with metoprolol in the treatment of elderly patients with severe heart failure. Methods: 60 elderly patients with severe heart failure were hospitalized from January 2010 to January 2013. The patients were randomly divided into losartan combined with metoprolol treatment group, losartan treatment group and control group with 20 patients in each group. Losartan plus losartan, losartan combined with metoprolol on the basis of routine treatment, and losartan and metoprolol on the basis of routine treatment. Heart function of all patients was measured before and 0.5 a 1.0 years after treatment. Results: there were no significant differences in heart function, left ventricular ejection fraction (LVEF) and type B brain natriuretic peptide (BNPP) between LVEF and B-type brain natriuretic peptide (BNPP) in the first three groups, while in losartan treatment group, there was no significant difference in heart function, left ventricular ejection fraction (LVEF) and type B brain natriuretic peptide (BNPP). The cardiac function and BNP in the losartan combined with metoprolol group were lower than those in the control group at 0.5 and 1.0 years after treatment, while the LVEF in the losartan combined metoprolol group was higher than that in the control group at 0.5 and 1.0 years after treatment, and in the losartan combined metoprolol group at 0.5 a after treatment, the cardiac function of the patients in the losartan combined with metoprolol group was significantly higher than that in the control group. There was no significant difference between BNP and losartan treatment group (P 0.05), but there was significant difference in cardiac function between Losartan and metoprolol group at 1.0 years after treatment, and there was significant difference between BNP and losartan treatment group (P 0.05), and there was no significant difference in mortality rate between three groups at 1.0 years after treatment. The least number of hospitalizations per year and the average length of stay were in the losartan combined with metoprolol treatment group. Conclusion: early combination of losartan and metoprolol is better than losartan alone in the treatment of elderly patients with severe heart failure.
【作者单位】：新疆医科大学第一附属医院心脏重症监护室;
【分类号】：R541.61

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