摘要
目的 分析贝那普利联合美托洛尔对慢性心力衰竭(CHF)患者左心重构与B型尿钠肽(BNP)水平的影响.方法 前瞻性选择医院2019年1月至2021年1月诊治的CHF患者120例.采用计算机随机数分组法将患者等分为对照组和观察组,60例/组.对照组口服贝那普利治疗,观察组口服贝那普利联合美托洛尔治疗.比较2组左室重构指标[左室舒张末期内径(LVEDD)、平均室壁反应力(MWS)、左方容积指数(LAVI)、左心室质量指数(LVMI)]、血清指标[高敏C反应蛋白(hsCRP)、血管内皮生长因子(VEGF)及B型尿钠肽(BNP)]、心功能指标[左心室射血分数(LVEF)、左心室收缩末期容积(LVESV)、左心室舒张末期容积(LVEDV)]、不良反应.结果 治疗前,2组LVEDD、MWS、LAVI、LVMI值比较差异无统计学意义(P＞0.05).治疗结束1d,观察组LVEDD、MWS、LAVI、LVMI 值均低于对照组(均P＜0.05).治疗前,2 组 hsCRP、VEGF、BNP、LVEF、LVESV、LVEDV、6MWD 值比较差异无统计学意义(P＞0.05),但在治疗结束1d,观察组hsCRP、BNP、LVESV、LVEDV值均低于对照组(均P＜0.05),VEGF、LVEF、6MWD值高于对照组(P＜0.05),且不良反应发生总率比较差异无统计学意义(P＞0.05).结论 贝那普利联合美托洛尔治疗CHF,能改善患者心功能,抑制左心重构,延缓心衰进展,抑制机体炎症反映,提升运动能力,且安全性较好,建议使用.
Abstract
Objective To analyze the effects of benazepril combined with metoprolol on left ventricular remodeling and brain natriuretic peptide(BNP)levels in patients with chronic heart failure(CHF).Methods From January 2019 to Janu-ary 2021,120 CHF patients in our hospital from January 2019 to January 2021 were prospectively selected,and randomly classified into two groups by computer,each with 60 cases.Control group received benazepril orally,while observation group received benazepril combined with metoprolol.Then comparison was conducted between two groups in terms of left ventricu-lar remodeling parameters[left ventricular end diastolic dimension(LVEDD),myocardial wall stress(MWS),left atrial vol-ume index(LAVI),left ventricular mass index(LVMI)],serum indicators[high sensitivity C-reactive protein(hs-CRP),vascular endothelial growth factor(VEGF)and BNP],cardiac function parameters[left ventricular ejection fraction(LVEF),left ventricular end systolic volume(LVESV),left ventricular end diastolic volume(LVEDV)],and adverse reactions.Results LVEDD,MWS,LAVI and LVMI values yielded no statistical difference between two groups before treatment(P＞0.05),and the four parameters at post-treatment 1 d were remarkably lower in observation group than in control group(all P＜0.05).Serum levels of hs-CRP,VEGF and BNP,and the values of LVEF,LVESV,LVEDV and 6-minute walking distance(6MWD)demonstrated no statistical difference between two groups before treatment(P＞0.05).At post-treatment 1 d,observation group had lower hs-CRP,BNP,LVESV and LVEDV as well as larger VEGF,LVEF and 6MWD than those of control group,with statistical difference(all P＜0.05).No statistical difference was found in overall adverse reaction rate(P＞0.05).Conclusion Benazepril combined with metoprolol in the treatment of CHF can effectively and safely improve cardiac function,inhibit left ventricular remodeling,attenuate the progress of heart failure,inhibit inflammatory response,and ameliorate exercise ability in patients.
维普
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