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目的分析酒石酸美托洛尔治疗老年冠心病不稳定型心绞痛患者的临床疗效及其对血清脑利钠肽(BNP)和可溶性细胞间黏附分子1(s ICAM-1)水平的影响。方法选取2014年1月—2016年11月广州市第一人民医院老年病科收治的老年冠心病不稳定型心绞痛患者92例,根据治疗方法分为对照组和观察组,每组46例。对照组患者予以阿司匹林肠溶片和硝酸异山梨酯治疗,观察组患者在对照组基础上予以酒石酸美托洛尔治疗;4周为1疗程,两组均连续治疗2个疗程。比较两组患者临床疗效、治疗前后血清BNP和s ICAM-1水平、不良反应/并发症发生情况及生活质量评分。结果观察组患者临床疗效优于对照组,差异有统计学意义(P<0.05)。治疗前两组患者血清BNP和s ICAM-1水平比较,差异无统计学意义(P>0.05);治疗后观察组患者血清BNP和s ICAM-1水平低于对照组(P<0.05)。两组患者不良反应/并发症发生率比较,差异无统计学意义(P>0.05)。治疗前两组患者生理功能评分、社会功能评分、精神状态评分、精力评分、生理职能评分、健康状况评分、躯体疼痛评分、情感职能评分比较,差异无统计学意义(P>0.05);治疗后观察组患者生理功能评分、社会功能评分、精神状态评分、精力评分、生理职能评分、健康状况评分、躯体疼痛评分、情感职能评分高于对照组(P<0.05)。结论酒石酸美托洛尔治疗老年冠心病心绞痛患者的临床疗效确切,可有效降低血清BNP和s ICAM-1水平,改善患者生活质量,且安全性较高。
Objective To analyze the clinical effects of metoprolol tartrate on senile patients with unstable angina pectoris and its effect on the levels of serum brain natriuretic peptide (BNP) and soluble intercellular adhesion molecule-1 (s ICAM-1). Methods From January 2014 to November 2016, 92 cases of elderly patients with unstable angina pectoris were admitted to Department of Geriatrics, Guangzhou First People’s Hospital. According to the treatment methods, they were divided into control group and observation group, 46 cases in each group. The patients in the control group were treated with aspirin enteric-coated tablets and isosorbide dinitrate. The patients in the observation group were treated with metoprolol tartrate on the basis of the control group. Four weeks were treated with one course of treatment, and the two groups were treated with two courses of continuous treatment. The clinical efficacy, serum BNP and s ICAM-1 levels, adverse reactions / complications and quality of life before and after treatment were compared between the two groups. Results The clinical efficacy of observation group was better than that of control group, the difference was statistically significant (P <0.05). The levels of serum BNP and s ICAM-1 in the two groups before treatment were not significantly different (P> 0.05). After treatment, the levels of serum BNP and s ICAM-1 in the observation group were lower than those in the control group (P <0.05). There was no significant difference in the incidence of adverse reactions / complications between the two groups (P> 0.05). There was no significant difference in the scores of physical function, social function score, mental status score, mental score, physical function score, health score, physical pain score and emotional function score between the two groups before treatment (P> 0.05) The physical function score, social function score, mental status score, mental score, physical function score, health status score, somatic pain score and emotional function score in observation group were higher than those in control group (P <0.05). Conclusion Metoprolol tartrate is effective in the treatment of elderly patients with angina pectoris, which can effectively reduce the serum levels of BNP and s ICAM-1, improve the quality of life of patients and have higher safety.