内科

目的探讨琥珀酸美托洛尔联合沙库巴曲缬沙坦治疗慢性充血性心力衰竭患者的临床疗效及对患者脑钠肽前体（NT-proBNP）、超敏C反应蛋白（hs-CRP）、心功能的影响。方法选取2018年1月至2020年1月我院收治的慢性充血性心力衰竭患者86例，使用随机数字法分为研究组与对照组，每组43例。对照组患者给予琥珀酸美托洛尔治疗，研究组患者给予琥珀酸美托洛尔联合沙库巴曲缬沙坦治疗，持续治疗10周。比较两组患者的临床治疗效果；比较两组患者治疗前后的血清NT-proBNP水平、hs-CRP水平以及心功能指标。结果治疗10周，研究组患者的临床疗效优于对照组，差异有统计学意义（P＜0.05）。治疗前，两组患者的血清NT-proBNP、hs-CRP水平比较，差异无统计学意义（P＞0.05）；治疗10周后，研究组患者的血清NT-proBNP、hs-CRP水平低于对照组，差异有统计学意义（P＜0.05）。治疗前，两组患者的左心室射血分数（LVEF）、每搏输出量（SV）、左心室舒张末期内径（LVEDD）及左心室收缩末期内径（LVESD）比较，差异无统计学意义（P＞0.05）；治疗10周后，研究组患者的LVEF、SV水平高于对照组，LVEDD、LVESD小于对照组，差异有统计学意义（P＜0.05）。结论琥珀酸美托洛尔联合沙库巴曲缬沙坦治疗可有效提高慢性充血性心力衰竭患者的临床治疗效果，降低NT-proBNP、hs-CRP水平，促进患者心功能恢复。

ObjectiveTo explore the clinical efficacy of metroprolol succinate combined with valsartan in the treatment of patients with chronic congestive heart failure and the effects on N-terminal pro-brain natriuretic peptide (NT-proBNP), high-sensitivity C-reactive protein (hs-CRP) and heart function. MethodsA total of 86 patients with chronic congestive heart failure who were admitted to our hospital from January 2018 to January 2020 were selected, and they were divided into study group and control group by the random number method, with 43 cases in each group. The control group administrated metroprolol succinate, whereas the study group administrated metroprolol succinate combined with valsartan, for a 10-week continuous treatment. The clinical therapeutic effects and the pre- and post-treatment serum NT-proBNP levels, hs-CRP levels and heart function were compared between the two groups. ResultsAfter 10 weeks of treatment, the clinical efficacy of the study group was superior to that of the control group, with a statistically significant difference (P＜0.05). Before treatment, there were no statistically significant differences in serum NT-proBNP and hs-CRP levels between the two groups (P＞0.05). After 10 weeks of treatment, the study group yielded lower levels of serum NT-proBNP and hs-CRP in the comparison of the control group, with statistically significant differences (P＜0.05). Before treatment, there were no statistically significant differences in the left ventricular ejection fraction (LVEF), stroke volume (SV), left ventricular end diastolic diameter (LVEDD) and left ventricular end systolic diameter (LVESD) between the two groups (P＞0.05). After 10 weeks of treatment, the study group yielded higher levels of LVEF and SV, while smaller LVEDD and LVESD as compared with the control group, with statistically significant differences (P＜0.05). ConclusionMetroprolol succinate combined with valsartan in the treatment of chronic congestive heart failure can effectively improve the clinical therapeutic effect, decrease the levels of NT-proBNP and hs-CRP, and promote recovery of heart function in patients.