依折麦布联合美托洛尔对老年冠状动脉粥样硬化性心脏病合并心力衰竭患者心功能、脂代谢及血管内皮功能的影响  

Effect of ezetimibe combined with metoprolol on cardiac function,lipid metabolism and vascular endothelial function in elderly patients with coronary atherosclerotic heart disease and heart failure

作　　者：邬小花 王星星 胡雪羚 Wu Xiao-hua;Wang Xing-xing;Hu Xue-ling(Department of Geriatrics with Integrated Traditional Chinese and Western Medicine,Zhoushan Hospital,Zhoushan 316000,China)

机构地区：[1]舟山医院中西医结合老年医学科,舟山316000

出　　处：《中国药物应用与监测》2024年第6期685-690,共6页Chinese Journal of Drug Application and Monitoring

摘　　要：目的探究依折麦布联合美托洛尔对老年冠状动脉粥样硬化性心脏病(CHD)合并心力衰竭患者心功能、脂代谢及血管内皮功能的影响。方法回顾性分析2022年1月至2023年12月收治的82例老年CHD合并心力衰竭患者,按照药物不同分为美托洛尔组与依折麦布组,各41例,两组患者入院后均予以常规治疗,美托洛尔组加以酒石酸美托洛尔片,依折麦布组在美托洛尔组基础上加以依折麦布片,均治疗6个月。比较两组临床疗效,治疗前后心功能、脂代谢、颈动脉斑块及血管内皮功能变化,统计两组治疗6个月内主要心血管不良事件(MACE)及药品不良反应发生情况。结果依折麦布组临床治疗总有效率(97.56%,40/41)与美托洛尔组(85.36%,35/41)比较,差异无统计学意义(χ^(2)=2.499,P=0.114);治疗6个月后,两组左室射血分数(LVEF)、高密度脂蛋白胆固醇(HDL-C)及一氧化氮(NO)水平均较治疗前升高(P<0.05),且依折麦布组治疗后LVEF、HDL-C、NO[分别为(60.74±6.86)%、(1.50±0.25)mmol·L^(-1)、(60.75±8.51)μmol·L^(-1)]均高于美托洛尔组[分别为(56.21±6.58)%、(1.34±0.22)mmol·L^(-1)、(56.43±6.08)μmol·L^(-1)](t=3.352,P=0.001;t=3.076,P=0.003;t=2.645,P=0.010);治疗6个月后,两组左室收缩末期内径(LVESD)、左室舒张末期内径(LVEDD)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、颈动脉内膜中层厚度(IMT)、斑块面积、双侧脉搏波传导速度(PWV)及内皮素-1(EF-1)水平均较治疗前降低(P<0.05),且依折麦布组LVESD、LVEDD、TC、LDL-C、IMT、PWV(左侧、右侧)、EF-1[分别为(35.72±3.65)mm、(49.03±5.43)mm、(4.36±0.56)mmol·L^(-1)、(2.58±0.41)mmol·L^(-1)、(0.87±0.12)mm、(1.54±0.23)mm2、(1022.87±199.54、1208.41±241.60)cm·s-1、(57.83±7.61)ng·L^(-1)]均低于美托洛尔组[分别为(37.45±3.18)mm、(52.39±5.83)mm、(4.71±0.67)mmol·L^(-1)、(2.80±0.43)mmol·L^(-1)、(1.01±0.27)mm、(2.65±1.08)mm^(2)、(1244.41±213.88、1347.19±263.15)cm·s^(-1)、Objective To explore the application of ezetimibe combined with metoprolol in elderly patients with coronary heart disease(CHD)complicated with heart failure and the influence on lipid metabolism and vascular endothelial function.Methods A total of 82 elderly patients with CHD admitted to Zhoushan Hospital from January 2021 to December 2023 were included and divided into metoprolol group and ezetimibe group according to the difference of medications.Both groups received conventional treatment,and the metoprolol group was given metoprolol tartrate tablet,whereas the ezetimibe group was supplemented with ezetimibe tablet on the basis of the metoprolol group.Both groups were treated for 6 months.The two groups were matched at 1:1 by the propensity matching scoring method to exclude the influence of confounding factors of baseline data,and finally 41 cases were included in each group.The clinical efficacy,and cardiac function,lipid metabolism,carotid artery plaque and vascular endothelial function before and after treatment were compared.Major adverse cardiovascular events(MACE)and adverse drug reactions were counted in the two groups within 6 months of treatment.Results There was no sta-tistical significance in the total effective rate of clinical efficacy between ezetimibe group(97.56%,40/41)and metoprolol group(85.36%,35/41)(χ^(2)=2.499,P=0.114).After 6 months of treatment,the left ventricular ejection fraction(LVEF),high density lipoprotein cholesterol(HDL-C)and nitric oxide(NO)in both groups were significantly increased(P<0.05),and the above indicators with(60.74±6.86)%,(1.50±0.25)mmol·L^(-1)and(60.75±8.51)μmol·L^(-1)in ezetimibe group were significantly higher than(56.21±6.58)%,(1.34±0.22)mmol·L^(-1)and(56.43±6.08)μmol·L^(-1)in metoprolol group(t=3.352,P=0.001;t=3.076,P=0.003;t=2.645,P=0.010).The left ventricular end systolic diameter(LVESD),left ventricular end diastolic diameter(LVEDD),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C),intima media thickness(IMT),plaque area,bilater

关 键 词：老年 冠心病 依折麦布 美托洛尔 脂代谢 心功能 血管内皮功能 

分 类 号：R541.6[医药卫生—心血管疾病] R541.4[医药卫生—内科学]