目的 探討氨氯地平聯(lián)合美托洛爾治療冠心病患者的臨床療效。方法 選取2019年1月-2020年6月在商丘市第四人民醫(yī)院就診的冠心病患者142例為研究對象，隨機(jī)分為對照組和治療組，每組各71例。對照組患者口服酒石酸美托洛爾片，1片/次，2次/d。治療組在對照組的基礎(chǔ)上口服苯磺酸氨氯地平片，1片/次，1次/d。兩組患者連續(xù)治療5周。觀察兩組患者臨床療效，同時(shí)比較治療前后兩組患者低密度脂蛋白膽固醇（LDL-C）和單核細(xì)胞趨化蛋白-1（MCP-1）水平，心率（HR）、左心室收縮末期內(nèi)徑（LVESD）、左心室舒張末期內(nèi)徑（LVEDD）和左心室射血分?jǐn)?shù)（LVEF）心功能水平，及炎癥因子白細(xì)胞介素-6（IL-6）、超敏C反應(yīng)蛋白（hs-CRP）和腫瘤壞死因子-α（TNF-α）水平。結(jié)果 治療后，對照組臨床總有效率為76.06%，顯著低于治療組的94.37%，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組患者LDL-C、MCP-1水平均明顯低于治療前（P<0.05），且治療組LDL-C、MCP-1水平均低于對照組（P<0.05）。治療后，兩組患者HR、LVESD、LVEDD水平均低于治療前（P<0.05），但是LVEF水平均高于治療前（P<0.05），且治療組HR、LVESD、LVEDD和LVEF水平均好于對照組（P<0.05）。治療后，兩組患者IL-6、hs-CRP、TNF-α水平均顯著低于治療前（P<0.05），且治療組IL-6、hs-CRP、TNF-α水平明顯低于對照組（P<0.05）。結(jié)論 氨氯地平聯(lián)合美托洛爾可有效提高冠心病的治療效果，降低患者的LDL-C、MCP-1、IL-6、hs-CRP、TNF-α水平，改善患者心功能，抑制機(jī)體炎癥反應(yīng)。

Objective To investigate the therapeutic effect of amlodipine combined with metoprolol in treatment of coronary heart disease. Methods Patients (142 cases) with coronary heart disease in the Fourth People's Hospital of Shangqiu from January 2019 to June 2020 were randomly divided into control and treatment groups, and each group had 71 cases. Patients in the control group were po administered with Metoprolol Tartrate Tablets, 1 tablet/time, twice daily. Patients in the treatment group were po administered with Amlodipine Besilate Tablets on the basis of the control group, 1 tablet/time, once daily. Patients in two groups were treated for 5 weeks. After treatment, the clinical efficacy was evaluated, and the levels of LDL-C and MCP-1, the cardiac function levels of HR, LVESD, LVEDD, and LVEF, and the inflammatory factors levels of IL-6, hs-CRP, and TNF-α in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 76.06%, which was significantly lower than 94.37% in the treatment group, and there were differences between two groups (P<0.05). After treatment, the levels of LDL-C and MCP-1 in two groups were significantly decreased (P<0.05), and which in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, the HR, LVESD, and LVEDD levels in two groups were significantly decreased (P<0.05), but the LVEF levels in two groups were significantly increased (P<0.05), and the cardiac function levels in the treatment group were significantly better than those in the control group (P<0.05). After treatment, the inflammatory factors levels of IL-6, hs-CRP, and TNF-α in two groups were significantly decreased (P<0.05), and which in the treatment group were significantly lower than those in the control group (P<0.05). Conclusion Amlodipine combined with metoprolol in treatment of coronary heart disease can effectively improve the therapeutic effect, reduce the levels of LDL-C, MCP-1, IL-6, hs-CRP and TNF-α, and inhibit the inflammatory reaction.

R972

國家科技支撐計(jì)劃課題（2013BAI09B01）