美托洛尔联合螺内酯治疗冠心病心力衰竭的效果及对血清炎性因子水平的影响  

Therapeutic effect of metoprolol combined with spironolactone on coronary heart disease complicated by heart failure and its influence on levels of serum inflammatory factors

作　　者：师磊 李宝寅 Shi Lei;Li Baoyin(Department of Cardiology,Kaifeng Central Hospital,Kaifeng 475000,China;WardⅠ,Department of Cardiovascular Medicine,Kaifeng Central Hospital,Kaifeng 475000,China)

机构地区：[1]开封市中心医院心内科,开封475000 [2]开封市中心医院心血管内科一病区,开封475000

出　　处：《中国实用医刊》2024年第24期74-77,共4页Chinese Journal of Practical Medicine

摘　　要：目的探讨美托洛尔联合螺内酯治疗冠心病心力衰竭的效果及对血清炎性因子水平的影响。方法队列研究。抽取2022年6月至2024年3月开封市中心医院收治的冠心病心力衰竭患者88例, 按随机数字表法分为对照组和观察组, 每组44例。对照组给予美托洛尔治疗, 观察组采用美托洛尔联合螺内酯治疗。比较两组临床疗效、心肌重构指标[左室收缩末期内径(LVESD)、左室舒张末期内径(LVEDD)、左室收缩末期容积(LVESV)、左室舒张末期容积(LVEDV)]、血清炎性因子[超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)]水平及不良反应。结果观察组整体疗效优于对照组(P<0.05)。治疗后, 两组LVESD、LVEDD、LVESV、LVEDV均低于治疗前, 且观察组低于对照组(P<0.05)。治疗后, 两组血清hs-CRP、IL-6、TNF-α水平均低于治疗前, 且观察组低于对照组(P<0.05)。对照组不良反应发生率(6.82%, 3/44)与观察组(13.64%, 6/44)比较差异未见统计学意义(P>0.05)。结论美托洛尔联合螺内酯治疗冠心病心力衰竭的效果显著, 可有效抑制心肌重构, 降低机体炎症因子水平, 且安全性高。Objective To investigate the therapeutic effect of metoprolol combined with spironolactone in the treatment of coronary heart disease complicated by heart failure,as well as the influence on levels of serum inflammatory factors.MethodsA total of 88 patients with coronary heart disease complicated by heart failure admitted to Kaifeng Central Hospital from June 2022 to March 2024 were selected for the cohort study.And they were divided into a control group and an observation group using a random number table,with 44 cases in each group.The control group was treated with metoprolol,while the observation group was treated with metoprolol combined with spironolactone.The clinical efficacy,myocardial remodeling indicators,including left ventricular end systolic diameter(LVESD),left ventricular end diastolic diameter(LVEDD),left ventricular end systolic volume(LVESV)and left ventricular end diastolic volume(LVEDV),levels of serum inflammatory factors,including hypersensitive C-reactive protein(hs-CRP),interleukin-6(IL-6),and tumor necrosis factor-α(TNF-α),and adverse reactions were compared between the two groups.ResultsThe overall therapeutic effect of the observation group was better than that of the control group(P<0.05).After treatment,both groups showed a decrease in myocardial remodeling indicators,including LVESD,LVEDD,LVESV and LVEDV,moreover,the above indicators in the observation group were lower than those in the control group(P<0.05).After treatment,the levels of serum hs-CRP,IL-6 and TNF-αin both groups were lower than those before treatment,and the observation group had lower levels than the control group(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the control group(6.82%,3/44)and the observation group(13.64%,6/44),P>0.05.ConclusionsMetoprolol combined with spironolactone has significant therapeutic effects on coronary heart disease complicated by heart failure,which can effectively inhibit myocardial remodeling and reduce levels of inflammator

关 键 词：冠心病 心力衰竭 美托洛尔 螺内酯 心肌重构 炎性因子 

分 类 号：R54[医药卫生—心血管疾病]