目的 研究左西孟旦聯(lián)合美托洛爾對老年慢性心力衰竭患者心功能、N端腦鈉肽前體水平和心室重構的影響。方法 選取2015年1月-2017年12月新疆兵團第一師醫(yī)院診治的老年慢性心力衰竭患者81例，按治療方法分為對照組41例、觀察組40例。對照組口服美托洛爾片治療，觀察組聯(lián)合給予左西孟旦注射液治療。比較兩組的治療有效率，心功能指標以及N端腦鈉肽前體水平。結果 觀察組老年慢性心力衰竭患者的總有效率為92.50%，明顯高于對照組的75.61%，差異有統(tǒng)計學意義（P<0.05）。治療后兩組患者的左心室射血分數(shù)、左心室舒張末期內徑、左心室后壁厚度均顯著改善，同組治療前后比較差異有統(tǒng)計學意義（P<0.05）；且觀察組更明顯，組間比較差異有統(tǒng)計學意義（P<0.05）。兩組治療后的N端腦鈉肽前體水平均明顯降低，同組治療前后比較差異有統(tǒng)計學意義（P<0.05）；且觀察組更為明顯，組間比較差異有統(tǒng)計學意義（P<0.05）。結論 左西孟旦聯(lián)合美托洛爾可以有效改善老年慢性心力衰竭患者的心功能，降低N端腦鈉肽前體水平，抑制心室重構，且具有較高的安全性。

Objective To investigate the clinical effect of levosimendan combined with metoprolol on cardiac function, blood potassium level and ventricular remodeling in elderly patients with chronic heart failure. Methods Selected 81 cases of elderly patients with chronic heart failure who were treated in our hospital from January 2015 to December 2017, divided into control group (n=41) and observation group (n=40) by treatment methods. The control group was treated with metoprolol tablets and the observation group was treated with Levosimendan Injection. The treatment efficiency, cardiac function index and N terminal brain natriuretic peptide level were compared between the two groups. Results After treatment, the total effective rate of the observation group was 92.50%, significantly higher than that of the control group 75.61% (P<0.05). The left ventricular ejection fraction, left ventricular end diastolic diameter and left ventricular posterior wall thickness in the two groups were significantly improved compared with those before treatment (P<0.05), and the improvement in the observation group was more significant (P<0.05). The levels of N terminal brain natriuretic peptide in the two groups were significantly decreased (P<0.05), and the observation group was more obvious (P<0.05). Conclusions Levosimendan combined with metoprolol can effectively improve cardiac function, reduce the level of N pro brain natriuretic peptide and inhibit ventricular remodeling in elderly patients with chronic heart failure, and has high safety.

R972

新疆市科技廳項目（2016YL08）