美托洛尔联合螺内酯治疗老年冠心病合并心力衰竭患者的临床疗效与安全性分析  

Analysis of the Clinical Efficacy and Safety of Metoprolol Combined with Spironolactone in Elderly Patients with Coronary Heart Disease and Heart Failure

作　　者：李轲 LI Ke(Department of Cardiology,Sheqi County People's Hospital,Nanyang Henan 473300,China)

机构地区：[1]社旗县人民医院心血管内科,河南南阳473300

出　　处：《临床研究》2025年第3期64-68,共5页Clinical Research

摘　　要：目的本研究主要针对老年患者冠心病并发心力衰竭的病例,深入分析联合使用美托洛尔与螺内酯的治疗效果及其安全性。方法选取2023年1月1日至2023年12月30日,在社旗县人民医院接受治疗的186例老年冠心病合并心力衰竭患者作为样本。通过随机数字表法,将患者分为对照组与观察组,每组93名患者。两组患者在入院后均遵循常规治疗措施。对照组患者口服螺内酯片剂。而观察组患者在对照组治疗基础上,加用酒石酸美托洛尔片剂。通过比较两组患者在治疗前后心功能[包括左室射血分数(LVEF)、左室收缩末期内径(LVESD)、左室舒张末期内径(LVEDD)]、氧化应激[如超氧化物歧化酶(SOD)浓度,丙二醛(MDA)含量]、炎症因子[如白细胞介素-6(IL-6)、C反应蛋白(CRP)]及血流动力学(心脏指数、心排出量)的变化,评估两组的临床疗效及不良反应差异。结果在开展治疗前,两组病例在LVEF、LVESD、LVEDD、SOD、MDA、IL-6、CRP、心脏指数及心排出量等指标比较,差异无统计学意义(P>0.05)。经过相应的治疗后,两组患者的LVEF、SOD、心脏指数及心排出量均显著提升,而LVESD、LVEDD、MDA、IL-6、CRP则有显著下降,差异有统计学意义(P<0.05)。在治疗后比较中,观察组在LVEF、SOD、心脏指数及心排出量的数值上显著高于对照组,而在LVESD、LVEDD、MDA、IL-6、CRP的数值上显著低于对照组,差异有统计学意义(P<0.05)。另外,对观察组的临床疗效进行评估,发现其治疗成功率明显高于对照组,,差异有统计学意义(P<0.05)。在治疗过程中,两组出现的不良反应比较,差异无统计学意义(P>0.05)。结论采用美托洛尔与螺内酯的联合疗法,对于治疗冠心病合并心力衰竭的患者,展现出明显的疗效,有助于提升患者的心脏功能,降低氧化应激水平,且治疗方法具有较高的安全性,适宜在临床使用。Objective This study focuses on elderly patients with coronary heart disease complicated by heart failure,analyzing the therapeutic effects and safety of combining metoprolol with spironolactone.Methods A total of 186 elderly patients with coronary heart disease combined with heart failure who were treated at Sheqi County People's Hospital from January 1,2023,to December 30,2023,were selected as samples.Patients were randomly divided into a control group and an observation group,with 93 patients in each group.Both groups received routine treatment after admission.The control group received oral spironolactone tablets,while the observation group received spironolactone in combination with tartrate metoprolol tablets.The changes in cardiac function[including left ventricular ejection fraction(LVEF),left ventricular end-systolic diameter(LVESD),left ventricular end-diastolic diameter(LVEDD)],oxidative stress[such as superoxide dismutase(SOD)levels and malondialdehyde(MDA)content],inflammatory factors[such as interleukin-6(IL-6)and C-reactive protein(CRP)],and hemodynamics(cardiac index and cardiac output)were compared between the two groups to assess the differences in clinical efficacy and adverse reactions.Results Before treatment,there were no significant differences between the two groups in LVEF,LVESD,LVEDD,SOD,MDA,IL-6,CRP,cardiac index,and cardiac output(P>0.05).After treatment,both groups showed significant improvements in LVEF,SOD,cardiac index,and cardiac output,while LVESD,LVEDD,MDA,IL-6,and CRP levels significantly decreased(P<0.05).In the post-treatment comparison,the observation group had significantly higher values of LVEF,SOD,cardiac index,and cardiac output compared to the control group,while their LVESD,LVEDD,MDA,IL-6,and CRP values were significantly lower(P<0.05).Additionally,the clinical efficacy assessment of the observation group revealed a significantly higher treatment success rate compared to the control group(P<0.05).The proportion of adverse reactions during treatment was similar between

关 键 词：美托洛尔 螺内酯 冠心病 心力衰竭 左心室射血分数 

分 类 号：R541.4[医药卫生—心血管疾病]