美托洛尔联合曲美他嗪治疗扩张型心肌病心力衰竭的临床观察  

Clinical observation of metoprolol combined with trimetazidine in the treatment of dilated cardiomyopathy and heart failure

作　　者：蔡小东 宋金花 廖春耀[2] Cai Xiaodong;Song Jinhua;Liao Chunyao(Gao'an People's Hospital,Jiangxi 330800;The Second Affiliated Hospital of Nanchang University,Jiangxi 330000)

机构地区：[1]高安市人民医院,江西330800 [2]南昌大学第二附属医院,江西330000

出　　处：《天津药学》2024年第5期36-39,共4页Tianjin Pharmacy

摘　　要：目的:观察美托洛尔联合曲美他嗪治疗扩张型心肌病心力衰竭的效果。方法:选取2021年1月—2022年12月本院治疗的扩张型心肌病心力衰竭患者80例,随机数字表法分为观察组40例和对照组40例。两组均参照指南进行常规治疗,同时口服曲美他嗪20 mg/次,3次/d;在此基础上对照组采用小剂量美托洛尔(≤100 mg/d)治疗,观察组采用大剂量美托洛尔(150 mg/d)治疗,连续治疗6个月。比较两组治疗前后的心功能指标、炎症指标和心室重构指标变化情况。结果:治疗前两组患者左室射血分数、左室舒张末期内径和左室收缩末期内径比较均无统计学差异(P>0.05);治疗后两组患者左室射血分数均较治疗前升高,左室舒张末期内径和左室收缩末期内径均较治疗前下降(P<0.05);观察组治疗后左室射血分高于对照组,左室舒张末期内径和左室收缩末期内径低于对照组(P<0.05)。治疗前两组患者C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、血管紧张素Ⅱ(AngⅡ)和转化生长因子β_(1)(TGF-β_(1))比较均无统计学差异(P>0.05);治疗后两组患者hs-CRP、IL-6、AngⅡ和TGF-β_(1)水平均较治疗前下降(P<0.05);且观察组低于对照组(P<0.05)。结论:大剂量美托洛尔(150 mg/d)较低剂量美托洛尔(≤100 mg/d)联合曲美他嗪对扩张型心肌病心力衰竭患者的心功能具有更好的改善作用,且能抑制炎症反应和心室重构。Objective:To observe the effect of metoprolol combined with trimetazidine in the treatment of heart failure in dilated cardiomyopathy.Methods:Eighty patients with heart failure and dilated cardiomyopathy treated in our hospital from January 2021 to December 2022 were selected and divided into an observation group(40 patients)and a control group(40 patients)using the random number table method.Both groups received conventional treatment according to the guidelines and simultaneously received trimetazidine orally,20 mg/time,three times a day.The control group was treated with a small dose of metoprolol(≤100 mg/day),and the observation group was treated with a large dose of metoprolol(150 mg/day).The treatment lasted for six months.Changes in cardiac function,inflammatory,and ventricular remodeling indicators before and after treatment were compared between the two groups.Results:Before treatment,there was no statistical difference in the left ventricular ejection fraction,left ventricular end-diastolic diameter,or left ventricular end-systolic diameter between the two groups of patients(P>0.05).After treatment,the left ventricular ejection fraction of both groups of patients increased compared to that before treatment,and the left ventricular end-diastolic diameter and left ventricular end-systolic diameter decreased compared to those before treatment(P<0.05).After treatment,the left ventricular ejection fraction of the observation group was higher than that of the control group,and the left ventricular end-diastolic and left ventricular end-systolic diameters were lower than those of the control group(P<0.05).Before treatment,there was no statistical difference in the C-reactive protein(hs-CRP),interleukin-6(IL-6),angiotensin Ⅱ(AngⅡ),and transforming growth factor β_(1)(TGF-β_(1))levels between the two groups of patients(P>0.05).After treatment,the levels of hs-CRP,IL-6,AngII,and TGF-β_(1) in both groups of patients were lower than those before treatment(P<0.05),and those in the observation group were low

关 键 词：扩张型心肌病 心力衰竭 美托洛尔 曲美他嗪 心室重构 左室舒张末期内径 左室收缩末期内径 

分 类 号：R972[医药卫生—药品]