吴雷辉

[摘要] 目的 探討厄贝沙坦氢氯噻嗪联合美托洛尔对重症心力衰竭急诊患者心功能的影响。方法 将2016年5月—2017年4月柳州市工人医院收治的112例重症心力衰竭急诊患者随机分成观察组和对照组，各56例。对照组患者实行常规急诊治疗，观察组患者在此基础上给予厄贝沙坦氢氯噻嗪与美托洛尔。对比两组患者的心功能、疗效及不良反应。结果 治疗后，观察组患者的左心室射血分数（LVEF）为（36.68±11.37）%，显著高于对照组的（30.13±10.56）%（P<0.01），而左心室收缩末期内径（LVESD）及左心室舒张末期内径（LVEDD）分别为（45.68±12.15）mm与（50.54±10.16）mm，明显低于对照组的（53.64±13.56）mm与（56.78±10.39）mm（P<0.01）；观察组患者的治疗总有效率为91.07%，显著高于对照组的76.79%（P<0.05）；观察组患者的不良反应发生率为10.71%，与对照组的8.93%比较，差异无统计学意义（P>0.05）。 结论 厄贝沙坦氢氯噻嗪联合美托洛尔能有效改善重症心力衰竭急诊患者的心功能，提高疗效，且不影响安全性。

[关键词] 厄贝沙坦氢氯噻嗪；美托洛尔；重症心力衰竭；心功能；疗效

[中图分类号] R4 [文献标识码] A [文章编号] 1674-0742（2018）02（a）-0001-04

The Effects of Irbesartan and Hydrochlorothiazide Combined with Metoprolol on Heart Function of Patients with Severe Heart Failure in Emergency

WU Lei-hui

Department of Emergency， Liuzhou Workers Hospital， Liuzhou， Guangxi， 545005 China

[Abstract] Objective This paper tries to discuss the effects of irbesartan and hydrochlorothiazide combined with metoprolol on heart function of patients with severe heart failure in emergency. Methods 112 cases of emergency patients with severe heart failure treated in Liuzhou Workers Hospital from May 2016 to April 2017 were randomly divided into observation group and control group， with 56 cases in each group. The control group was treated with routine emergency treatment. The observation group was treated with irbesartan and hydrochlorothiazide combined with metoprolol. The heart function， curative effect and adverse reaction were compared between the two groups. Results After treatment， the left ventricular ejection fraction of observation group patients was（36.68±11.37）%， which was markedly higher than（30.13±10.56）% in control group （P<0.01）. The left ventricular end-systolic dimension and left ventricular end-diastolic dimension of observation group patients were （45.68±12.15）mm and（50.54±10.16）mm， which were evidently lower than （53.64±13.56）mm and（56.78±10.39）mm in control group（P<0.01）. The effective rate of treatment in observation group patients was 91.07%， which was remarkably higher than 76.79% of control group（P<0.05）. The rate of adverse reaction in observation group patients was 10.71%， which had no obvious difference with 8.93% of control group （P>0.05）. Conclusion The irbesartan and hydrochlorothiazide combined with metoprolol can effectively improve the heart function and curative effect of patients with severe heart failure in emergency. It doesnt affect security.

[Key words] Irbesartan and hydrochlorothiazide； Metoprolol； Severe heart failure； Heart function； Curative effect

心力衰竭是由于心脏收缩或舒张功能障碍，无法将回心血量及时、充分地排出，致使静脉血液淤积，动脉血液灌注不足而引发的心脏循环障碍症候群[1]。重症心力衰竭患者不但病情更为危重，且病死率更高，急诊治疗难度大。随着肾素-血管紧张素-醛固酮系统对人体心血管事件作用机制的逐渐阐明，β受体阻滞剂及血管紧张素转化酶抑制剂在心力衰竭治疗中的应用效果也得到临床的肯定[2]。该研究采用厄贝沙坦氢氯噻嗪联合美托洛尔对2016年5月—2017年4月该院收治的112例重症心力衰竭急诊患者进行治疗，观察心功能指标的变化和临床疗效，现报道如下。

1 资料与方法

1.1 一般资料

方便选取该院收治的112例重症心力衰竭急诊患者，按随机数字表法分成观察组和对照组，每组56例。……