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目的探讨美托洛尔联合瑞舒伐他汀治疗心力衰竭合并高脂血症患者的临床疗效及对预后的影响。方法选取2015年6月6日—2016年6月6日在该院接受治疗的心力衰竭合并高脂血症患者84例,将患者分为二组,每组各42例。对照组给予瑞舒伐他汀进行治疗,观察组给予美托洛尔联合瑞舒伐他汀进行治疗,治疗2个月后,比较二组患者的临床疗效;比较二组患者治疗前后LVEDD(左室舒张末内径)、LVESD(左室收缩末内径)、LVEF(心功能指标如射血分数)、TC(总胆固醇)、TG(甘油三酯)、HDL-C(高密度脂蛋白胆固醇)、LDL-C(低密度脂蛋白胆固醇)情况;随访1年,比较二组患者再次住院率与死亡率发生情况。结果观察组总有效率(92.9%)高于对照组(69.1%),二组比较差异有统计学意义(P<0.05)。治疗前,二组患者的LVEDD、LVESD、LVEF比较,差异无统计学意义(P>0.05),治疗后,二组患者的LVEDD、LVESD都有所降低,但是观察组LVEDD(46.4±4.4)mm低于对照组(54.8±4.8)mm,观察组LVESD(40.9±3.2)mm低于对照组(46.5±3.5)mm,治疗后,二组患者的LVEF都有所升高,但是观察组的LVEF(55.1±4.2)%高于对照组(41.3±3.4)%,二组比较差异具有统计学意义(P<0.05)。治疗前,二组患者的TC、TG、HDL-C、LDL-C比较,差异无统计学意义(P>0.05),治疗后,二组患者的TC、TG、LDL-C都有所降低,但是观察组TC(4.4±0.9)mmol/L低于对照组(5.6±1.2)mmol/L,观察组TG(1.7±0.5)mmol/L低于对照组(2.1±0.4)mmol/L,二组患者的LDL-C有所降低,但是观察组的LDL-C(2.4±0.5)mmol/L低于对照组(3.3±0.6)mmol/L;治疗后,二组患者的HDL-C都有所升高,但是观察组(1.5±0.3)mmol/L高于对照组(1.1±0.2)mmol/L;二组比较差异具有统计学意义(P<0.05)。观察组再次住院率(7.1%)低于对照组(26.2%),观察组死亡率(4.8%)低于对照组(19.0%),二组比较差异有统计学意义(P<0.05)。结论对心力衰竭合并高脂血症患者给予美托洛尔联合瑞舒伐他汀治疗,效果显著,能提高治疗的总有效率,更能够有效调控血脂浓度,也能改善患者心脏功能,还能有效降低患者的再次住院率和死亡率,值得推广。
Objective To investigate the clinical efficacy of metoprolol combined with rosuvastatin in the treatment of patients with congestive heart failure and hyperlipidemia and its prognostic impact. Methods From June 6, 2015 to June 6, 2016, 84 patients with congestive heart failure and hyperlipidemia treated in the hospital were divided into two groups, 42 patients in each group. The control group was treated with rosuvastatin. The observation group was treated with metoprolol combined with rosuvastatin. After 2 months of treatment, the clinical efficacy was compared between the two groups. The LVEDD (left ventricular diastolic dimension) End-end diameter), LVESD (end-systolic diameter), LVEF (cardiac function index such as ejection fraction), TC (total cholesterol), TG (triglyceride), HDL-C (high density lipoprotein cholesterol), LDL- C (low density lipoprotein cholesterol); follow-up of 1 year, compared two groups of patients re-hospitalization and mortality incidence. Results The total effective rate (92.9%) in the observation group was higher than that in the control group (69.1%). There was significant difference between the two groups (P <0.05). Before treatment, LVEDD, LVESD and LVEF in the two groups had no significant difference (P> 0.05). After treatment, LVEDD and LVESD in both groups were decreased, but LVEDD (46.4 ± 4.4) mm in observation group (54.8 ± 4.8) mm in the control group. The LVESD (40.9 ± 3.2) mm in the observation group was lower than that in the control group (46.5 ± 3.5) mm. After treatment, the LVEF in both groups was increased. However, the LVEF (55.1 ± 4.2)% was higher than that of the control group (41.3 ± 3.4)%, the difference between the two groups was statistically significant (P <0.05). There was no significant difference in TC, TG, HDL-C and LDL-C between the two groups before treatment (P> 0.05). After treatment, the levels of TC, TG and LDL- However, TC (4.4 ± 0.9) mmol / L in the observation group was significantly lower than that in the control group (5.6 ± 1.2 mmol / L) LDL-C in the patients decreased, but the LDL-C (2.4 ± 0.5) mmol / L in the observation group was lower than that in the control group (3.3 ± 0.6) mmol / L; after treatment, HDL-C in both groups had (1.5 ± 0.3) mmol / L in the observation group was significantly higher than that in the control group (1.1 ± 0.2) mmol / L. The difference between the two groups was statistically significant (P <0.05). The rehospitalization rate (7.1%) in the observation group was lower than that in the control group (26.2%). The mortality rate in the observation group (4.8%) was lower than that in the control group (19.0%). There was significant difference between the two groups (P <0.05). Conclusions Metoprolol combined with rosuvastatin in patients with heart failure and hyperlipidemia is effective, which can improve the total effective rate of treatment, regulate the blood lipid concentration effectively and improve the heart function of patients. Reduce the patient’s re-hospitalization rate and mortality, it is worth promoting.