李兆雷

【摘要】 目的：分析老年慢性心力衰竭（CHF）治療中美托洛尔联合阿托伐他汀的临床疗效及对血清NT-proBNP、Cys C的影响。方法：选择本院2018年5月-2019年5月收治的78例老年CHF患者为研究对象。将其随机分为试验组和参照组，每组39例。参照组采用临床常规治疗，试验组在参照组基础上采用美托洛尔联合阿托伐他汀治疗。比较两组临床疗效、心功能指标、血清NT-proBNP、Cys C含量、不良反应发生情况。结果：试验组临床总有效率为94.87%，显著高于参照组的69.23%（P<0.05）。治疗8周后，试验组LVEDD、LVESD均显著低于参照组，LVEF显著高于参照组（P<0.05）。治疗8周后，试验组血清NT-proBNP、Cys C均显著低于参照组（P<0.05）。试验组不良反应发生率为7.69%，与参照组5.13%比较（P>0.05）。结论：美托洛尔与阿托伐他汀联合可有效降低老年CHF患者机体血清

NT-proBNP、Cys C含量，改善心功能，防止疾病加重、进展，且安全性高。

【关键词】 美托洛尔 阿托伐他汀 慢性心力衰竭 血浆氨基末端脑钠肽前体 胱抑素C

Metoprolol Combined with Atorvastatin for Elderly Efficacy of Chronic Heart Failure Patients and Its Effect on Serum NT-proBNP and Cys C/LI Zhaolei. //Medical Innovation of China， 2021， 18（07）： 0-055

[Abstract] Objective： To analyze the clinical efficacy of Metoprolol combined with Atorvastatin in the treatment of elderly chronic heart failure （CHF） and its effect on serum NT-proBNP and Cys C. Method： A total of 78 elderly patients with CHF admitted to our hospital from May 2018 to May 2019 were selected as the research objects. They were randomly divided into experimental group and reference group， 39 cases in each group. The control group was treated with routine clinical treatment， and the experimental group was treated with Metoprolol combined with Atorvastatin on the basis of the reference group. Clinical efficacy， cardiac function indexes， serum NT-proBNP， Cys C content and the incidence of adverse reactions were compared between the two groups. Result： The total effective rate of the experimental group was 94.87%， which was significantly higher than 69.23% of the reference group （P<0.05）. After 8 weeks of treatment， LVEDD and LVESD in the test group were significantly lower than those in the reference group， and LVEF was significantly higher than that in the reference group （P<0.05）. After 8 weeks of treatment， serum NT-proBNP and Cys C in experimental group were significantly lower than those in the reference group （P<0.05）. The incidence of ADR in the test group was 7.69%， compared with 5.13% in the control group （P>0.05）. Conclusion： The combination of Metoprolol and Atorvastatin can effectively reduce serum NT-proBNP and Cys C content in elderly patients with CHF， improve cardiac function， and prevent disease aggravation and progression， with high safety.

[Key words] Metoprolol Atorvastatin Chronic heart failure Plasma amino-terminal brain natriuretic peptide precursor Cystatin C

First-authors address： Jiamusi Maternal and Child Health Hospital， Jiamusi 154002， China

doi：10.3969/j.issn.1674-4985.2021.07.013

慢性心力衰竭（CHF）是一种临床常见病，主要是由于冠心病患者机体血流动力学负荷过重或在炎症反应作用下，出现心肌结构以及功能改变、心脏排血功能障碍的一种临床综合征[1-2]。近年来，随着我国人口老龄化进程推进，人们饮食结构、生活方式不断变化，CHF发生率显著增高[3]。当前，对于CHF临床常规治疗以硝酸酯类、利尿剂等为主，目的是延缓患者疾病发展，但并未取得理想的治疗效果。美托洛尔具有降低心肌耗氧量、防止心肌收缩的功效，是临床治疗心血管疾病的常用药。阿托伐他汀具有稳定斑块、改善血管内皮功能、抗炎等功效，近年来被逐渐应用于心血管疾病治疗中[4]。NT-proBNP具有利尿、血管舒张功能，主要由心室细胞分泌，可间接的反映心功能[5]。……