厄贝沙坦氢氯噻嗪联合美托洛尔急诊治疗老年重症心力衰竭的临床效果  

Clinical effect of irbesartan hydrochlorothiazide combined with metoprolol in emergency treatment of elderly patients with severe heart failure

作　　者：黄河 温江华 吴英春 HUANG He;WEN Jianghua;WU Yingchun(Department of Critical Care Medicine,People′s Hospital of Wanning,Hainan Province,Wanning 571500,China)

机构地区：[1]海南省万宁市人民医院重症医学科,571500

出　　处：《临床合理用药杂志》2022年第26期1-4,共4页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的观察厄贝沙坦氢氯噻嗪联合美托洛尔急诊治疗老年重症心力衰竭的临床效果。方法选取2019年1月—2020年12月万宁市人民医院急诊科收治的老年重症心力衰竭患者128例为研究对象,以随机数字表法分为观察组和对照组,每组64例。对照组患者在常规基础上加美托洛尔治疗,观察组则在对照组基础上加厄贝沙坦氢氯噻嗪治疗,2组均连续治疗3个月。比较2组患者的治疗效果,治疗前后心功能分级改善情况、心率、左室射血分数(LVEF)、血压指标和脑利钠肽(BNP)水平及随访情况。结果观察组患者治疗总有效率为92.19%,高于对照组的79.69%(χ^(2)=4.137,P=0.042);治疗3个月后,2组患者心功能分级较治疗前均改善,且观察组心功能分级改善情况优于对照组(P<0.05);2组心率、收缩压、舒张压较治疗前降低,LVEF较治疗前升高,且观察组降低/升高的幅度大于对照组(P均<0.01);2组患者BNP水平均较治疗前降低,且观察组低于对照组(P均<0.01);随访半年,观察组再住院2例,对照组再住院8例,观察组患者随访情况(3.13%vs.12.50%)好于对照组,差异有统计学意义(χ^(2)=3.905,P=0.048)。结论厄贝沙坦氢氯噻嗪联合美托洛尔用于老年重症心力衰竭急诊治疗的效果确切,可提高患者的心功能,有效降低血压、心率和BNP水平,且用药后患者的复发率低,值得临床推广应用。Objective To study the clinical effect of irbesartan hydrochlorothiazide combined with metoprolol in emergency treatment of elderly patients with severe heart failure.Methods A total of 128 elderly patients with severe heart failure who were admitted to the emergency department of People′s Hospital of Wanning from January 2019 to December 2020 were selected as the research objects,and divided into an observation group and a control group by random number table meth⁃od,with 64 cases in each group.The control group was treated with metoprolol on the basis of routine treatment,while the observation group was treated with metoprolol and irbesartan hydrochlorothiazide on the basis of routine treatment.The treatment effect,improvement of cardiac function classification,heart rate,left ventricular ejection fraction(LVEF),blood pressure index,brain natriuretic peptide(BNP)levels before and after treatment and follow⁃up were compared between the two groups.Results The total effective rate of patients in the observation group was 92.19%,which was higher than 79.69%in the control group(χ^(2)=4.137,P=0.042).After 3 months of treatment,the cardiac function grades of both groups were improved compared with those before treatment,and the improvement of cardiac function grades in the observation group was better than that in the control group(P<0.05);The heart rate,systolic blood pressure and diastolic blood pressure in the two groups were lower than those before treatment,and LVEF was higher than that before treatment,and the decrease/increase range in the observation group was greater than that in the control group(all P<0.01);The BNP levels in the two groups were lower than those before treatment,and the observation group was lower than the control group(all P<0.01).After six months of follow⁃up,2 patients in the observation group and 8 patients in the control group were re⁃hospitalized.The follow⁃up of the patients in the observation group(3.13%vs.12.50%)was better than that in the control group,and the differen

关 键 词：重症心力衰竭 老年人 厄贝沙坦氢氯噻嗪 美托洛尔 急诊治疗 

分 类 号：R541.6[医药卫生—心血管疾病]