平兆幸
[关键词] 冠心病;心力衰竭;曲美他嗪;美托洛尔;心功能;生命体征
[中图分类号] R541.4 [文献标识码] B [文章编号] 1673-9701（2021）20-0051-03
Application of trimetazidine combined with metoprolol in the treatment of patients with coronary heart disease and heart failure
PING Zhaoxing
Department of Cardiovascular Medicine，Pingxiang No.2 People′s Hospital，Pingxiang 337000，China
[Abstract] Objective To investigate the clinical efficacy of trimetazidine combined with metoprolol in the treatment of coronary heart disease （CHD） and heart failure （HF），and to provide a reference for the clinical medication. Methods The clinical data of 80 patients with CHD and HF admitted to our hospital from October 2017 to November 2019 were analyzed retrospectively. 40 patients treated with metoprolol alone were included in the control group，and 40 patients treated with metoprolol and trimetazidine were included in the observation group. The changes in the levels of cardiac function [left ventricular end-systolic diameter （LVESD），left ventricular end-diastolic dimension （LEVDD）] and vital signs [diastolic blood pressure （DBP），systolic blood pressure （SBP），heart rate （HR）] before and after treatment were compared between the two groups. Results Before treatment，the levels of LVEDD，LVESD，LVEF，SBP，DBP and HR in the observation group were not significantly different from those in the control group （P>0.05）.Three months after treatment，the levels of LVESD and LEVDD were lower in the observation group [（53.24±2.47） mm，（34.15±2.25） mm] than those in the control group [（58.69±3.45） mm，（39.86±2.64） mm]，LVEF level was higher in the observation group [（49.96±3.36）%] than that in the control group [（44.16±3.15）%]，with statistically significant differences（t= 8.124，10.411，7.965，P<0.001）.The levels of DBP，SBP and HR were lower in the observation group [（114.37±11.16） mmHg，（75.98±7.64） mmHg，（83.54±8.78） beats/min] than those in the control group [（134.87±13.51） mmHg，（89.63±8.69） mmHg，（91.18±10.44） beats/min]，with statistically significant differences （t=7.399，7.457，3.542，P=0.000，0.000，0.001）. Conclusion Trimetazidine and metoprolol are helpful to promote the recovery of patients with CHD and HF.
[Key words] Coronary heart disease;Heart failure;Trimetazidine;Metoprolol;Cardiac function;Vital signs
冠心病为临床中发病率较高的一种疾病，多发群体为老年人，主要因冠状动脉堵塞或狭窄所致，主要临床症状为胸痛、出汗、呼吸困难等，且活动后加重，若未得到及时治疗，将严重威胁患者生命健康[1]。另外，冠心病极易引发多种并发症发生，以心力衰竭较为常见，主要因冠心病导致心脏血流量减少，导致心功能受损，已成为冠心病病死的主要因素[2-3]。目前，药物为临床治疗冠心病心力衰竭的主要手段，曲美他嗪与美托洛尔均为临床治疗该疾病的主要药物，前者具有改善微循环作用，可起到有效保护心肌细胞的作用，后者具有显著的抗心力衰竭作用，故临床常将两种药物联合应用[4-5]。基于此，本研究旨在分析曲美他嗪与美托洛尔联合应用于该疾病的治疗效果，为临床用药提供指导。
