目的 探究培哚普利叔丁胺聯(lián)合地高辛治療老年充血性心衰患者的臨床療效。方法 選取2022年5月—2023年5月在滄州市中心醫(yī)院治療的老年充血性心力衰竭患者115例，根據(jù)治療方案分成對照組（57例）和治療組（58例）。對照組口服地高辛片，0.25 mg/次，1次/d；治療組在對照組基礎(chǔ)上口服培哚普利叔丁胺片，4 mg/次，1次/d。兩組患者均治療8周。觀察兩組患者臨床療效，比較治療前后兩組患者生活質(zhì)量和運(yùn)動耐力，心室重構(gòu)指標(biāo)左心室后壁厚度（LVPWT）、左心室舒張末期后壁厚度（LVPWd）、左心室收縮末期后壁厚度（LVPWs）和左心室舒張末期球形指數(shù)（LVSId）水平，及血清聚集素蛋白（Clusterin）、胱抑素C（Cys-C）、可溶性細(xì)胞間粘附分子1（sICAM-1）和同型半胱氨酸（Hcy）水平。結(jié)果 治療后，治療組和對照組臨床總有效率分別為93.10%、75.44%（P＜0.05）。治療后，兩組患者M(jìn)LHFQ評分均明顯降低，6 min步行距離均明顯提升（P＜0.05），且治療組MLHFQ評分和6 min步行距離改善更為明顯（P＜0.05）。治療后，兩組患者LVPWT、LVPWd、LVPWs、LVSId、Clusterin、Cys-C、sICAM-1和Hcy水平均明顯降低（P＜0.05），且治療組這些指標(biāo)水平明顯低于對照組（P＜0.05）。結(jié)論 培哚普利叔丁胺聯(lián)合地高辛治療老年充血性心力衰竭療效顯著，不僅能夠顯著改善患者運(yùn)動耐力和生活質(zhì)量，同時(shí)還能夠促進(jìn)血清學(xué)指標(biāo)的恢復(fù)并有效抑制心室重構(gòu)。

Objective To explore the clinical efficacy of perindopril tert-butylamine combined with digoxin in treatment of elderly congestive heart failure. Methods Patients (115 cases) with elderly congestive heart failure in Cangzhou Central Hospital from May 2022 to May 2023 were randomly divided into control (57 cases) and treatment (58 cases) group. Patients in the control group were po administered with Digoxin Tablets, 0.25 mg/time, once daily. Patients in the treatment group were po administered with Perindopril tert-Butylamine Tablets on the basis of the control group, 4 mg/time, once daily. Patients in two groups were treated for 8 weeks. After treatment, the clinical evaluations were evaluated, the quality of life and exercise endurance, the levels of ventricular remodeling indicators LVPWT, LVPWd, LVPWs and LVSId, the levels of serum Clusterin, Cys-C, sICAM-1 and Hcy in two groups before and after treatment were compared. Results After treatment, the total clinical effective rate of the treatment group and the control group was 93.10% and 75.44% respectively (P < 0.05). After treatment, the MLHFQ score was significantly decreased, and the 6 min walking distance was significantly increased in two groups (P < 0.05), and the MLHFQ score and 6 min walking distance were significantly improved in the treatment group (P < 0.05). After treatment, the levels of LVPWT, LVPWd, LVPWs, LVSId, Clusterin, Cys-C, sICAM-1 and Hcy in the two groups were significantly decreased (P < 0.05), and the levels of these indexes in the treatment group were significantly lower than those in the control group (P < 0.05). Conclusion The combination of perindopril tert butylamine and digoxin tablets has a significant therapeutic effect on elderly patients with congestive heart failure. It can not only significantly improve exercise endurance and quality of life, but also promote the recovery of serological indicators and effectively inhibit ventricular remodeling, which has clinical promotion value.

R972

河北省重點(diǎn)研發(fā)計(jì)劃項(xiàng)目（20211799）