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美托洛尔联合托拉塞米治疗老年退行性心脏瓣膜病心力衰竭的疗效及其对NT-proBNP水平的影响

Efficacy of metoprolol combined with torasemide in elderly patients with degenerative valvular heart disease and heart failure and its influence on NT-proBNP levels.

作者信息

Ren Kai, Feng Jinping, Yang Xuwen, Ren Bei, Guo Yujun

机构信息

Kai Ren Department of Cardiology, Tianjin Chest Hospital, Tianjin 300222, P.R. China.

Jinping Feng Department of Cardiology, Tianjin Chest Hospital, Tianjin 300222, P.R. China.

出版信息

Pak J Med Sci. 2023 Jul-Aug;39(4):945-949. doi: 10.12669/pjms.39.4.7465.

Abstract

OBJECTIVE

To investigate the efficacy of metoprolol combined with torasemide in elderly patients with degenerative valvular heart disease (DVHD) and heart failure and its influence on N-terminal pro-B-type natriuretic peptide (NT-proBNP) concentrations.

METHODS

The records of 129 DVHD patients ≥60 years old with heart failure diagnosed and treated in our hospital from January 2020 to February 2022 were retrospectively selected. According to the treatment records, 62 patients received metoprolol treatment (Control-group), and 67 patients received metoprolol combined with torasemide treatment (Observation-group). The changes in cardiac function, NT-proBNP and inflammatory factor concentrations and clinical efficacy were analyzed and compared between the two groups before and after treatment.

RESULTS

After treatment, left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD) and the mitral ratio of peak early to late diastolic filling velocity (E/A) were lower, with a greater decrease in the Observation-group compared to the Control-group (<0.05). After treatment, NT-proBNP and interleukin-1beta (IL-1β), tumor necrosis factor-alpha (TNF-α), interleukin 6 (IL-6) concentrations were lower in both groups, with a greater decrease in the Observation-group compared to the Control-group (<0.05). The total clinical efficacy of the Observation-group was significantly higher than the Control-group (<0.05). There was no significant difference in the total incidence of adverse drug reactions between the two groups (>0.05).

CONCLUSION

Metoprolol combined with torasemide has a significant therapeutic effect on DVHD patients with heart failure. This drug combination improved cardiac function, reduced NT-proBNP concentrations and has good safety.

摘要

目的

探讨美托洛尔联合托拉塞米治疗老年退行性心脏瓣膜病(DVHD)合并心力衰竭的疗效及其对N末端B型利钠肽原(NT-proBNP)浓度的影响。

方法

回顾性选取2020年1月至2022年2月在我院诊断并治疗的129例年龄≥60岁的DVHD合并心力衰竭患者的病历。根据治疗记录,62例患者接受美托洛尔治疗(对照组),67例患者接受美托洛尔联合托拉塞米治疗(观察组)。分析比较两组治疗前后心功能、NT-proBNP及炎症因子浓度变化和临床疗效。

结果

治疗后,两组左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)及二尖瓣舒张早期与晚期峰值充盈速度比值(E/A)均降低,且观察组较对照组降低更明显(<0.05)。治疗后,两组NT-proBNP及白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)、白细胞介素6(IL-6)浓度均降低,且观察组较对照组降低更明显(<0.05)。观察组总临床疗效显著高于对照组(<0.05)。两组药物不良反应总发生率比较,差异无统计学意义(>0.05)。

结论

美托洛尔联合托拉塞米治疗DVHD合并心力衰竭患者疗效显著。该药物组合可改善心功能,降低NT-proBNP浓度,且安全性良好。

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