中国医学前沿杂志（电子版）
中國醫學前沿雜誌（電子版）
중국의학전연잡지（전자판）
CHINESE JOURNAL OF THE FRONTIERS OF MEDICAL SCIENCE(ELECTRONIC VERSION)
2015年
7期
138-140
,共3页
重症心力衰竭%老年%厄贝沙坦氢氯噻嗪%美托洛尔
重癥心力衰竭%老年%阨貝沙坦氫氯噻嗪%美託洛爾
중증심력쇠갈%노년%액패사탄경록새진%미탁락이
Severe heart failure%Elderly%Irbesartan hydrochlorothiazide%Metoprolol
目的：探讨老年重症心力衰竭患者急诊内科治疗方案及临床效果。方法选取本院急诊科2012年1月至2013年6月收治的老年重症心力衰竭患者90例为研究对象，按就诊顺序编号分为观察组和对照组，每组各45例。对照组患者仅接受急诊内科常规治疗，观察组患者在对照组基础上口服厄贝沙坦氢氯噻嗪和美托洛尔，两组患者均随访1年。比较两组患者临床疗效、治疗前后左室射血分数（LVEF）和B型脑钠肽（BNP）的变化情况、不良反应发生情况、复发率及死亡率。结果观察组患者治疗总有效率为95.56%（43/45），对照组为77.78%（35/45），两组比较差异具有显著性（P＜0.05）。两组患者治疗前LVEF和BNP比较差异无显著性（P＞0.05），治疗后观察组患者LVEF明显升高，两组BNP均明显降低，观察组LVEF和BNP变化幅度均明显大于对照组（P＜0.05）。两组均未见明显不良反应；观察组患者心力衰竭复发率为4.44%，死亡率为2.22%；对照组患者心力衰竭复发率为26.67%，死亡率为22.22%，两组比较差异均有显著性（P＜0.05）。结论老年重症心力衰竭患者在接受急诊内科常规治疗基础上口服贝沙坦氢氯噻嗪和美托洛尔，疗效显著，可有效改善患者心功能，安全性较高，心力衰竭复发率和死亡率较低，值得临床推广应用。
目的：探討老年重癥心力衰竭患者急診內科治療方案及臨床效果。方法選取本院急診科2012年1月至2013年6月收治的老年重癥心力衰竭患者90例為研究對象，按就診順序編號分為觀察組和對照組，每組各45例。對照組患者僅接受急診內科常規治療，觀察組患者在對照組基礎上口服阨貝沙坦氫氯噻嗪和美託洛爾，兩組患者均隨訪1年。比較兩組患者臨床療效、治療前後左室射血分數（LVEF）和B型腦鈉肽（BNP）的變化情況、不良反應髮生情況、複髮率及死亡率。結果觀察組患者治療總有效率為95.56%（43/45），對照組為77.78%（35/45），兩組比較差異具有顯著性（P＜0.05）。兩組患者治療前LVEF和BNP比較差異無顯著性（P＞0.05），治療後觀察組患者LVEF明顯升高，兩組BNP均明顯降低，觀察組LVEF和BNP變化幅度均明顯大于對照組（P＜0.05）。兩組均未見明顯不良反應；觀察組患者心力衰竭複髮率為4.44%，死亡率為2.22%；對照組患者心力衰竭複髮率為26.67%，死亡率為22.22%，兩組比較差異均有顯著性（P＜0.05）。結論老年重癥心力衰竭患者在接受急診內科常規治療基礎上口服貝沙坦氫氯噻嗪和美託洛爾，療效顯著，可有效改善患者心功能，安全性較高，心力衰竭複髮率和死亡率較低，值得臨床推廣應用。
목적：탐토노년중증심력쇠갈환자급진내과치료방안급림상효과。방법선취본원급진과2012년1월지2013년6월수치적노년중증심력쇠갈환자90례위연구대상，안취진순서편호분위관찰조화대조조，매조각45례。대조조환자부접수급진내과상규치료，관찰조환자재대조조기출상구복액패사탄경록새진화미탁락이，량조환자균수방1년。비교량조환자림상료효、치료전후좌실사혈분수（LVEF）화B형뇌납태（BNP）적변화정황、불량반응발생정황、복발솔급사망솔。결과관찰조환자치료총유효솔위95.56%（43/45），대조조위77.78%（35/45），량조비교차이구유현저성（P＜0.05）。량조환자치료전LVEF화BNP비교차이무현저성（P＞0.05），치료후관찰조환자LVEF명현승고，량조BNP균명현강저，관찰조LVEF화BNP변화폭도균명현대우대조조（P＜0.05）。량조균미견명현불량반응；관찰조환자심력쇠갈복발솔위4.44%，사망솔위2.22%；대조조환자심력쇠갈복발솔위26.67%，사망솔위22.22%，량조비교차이균유현저성（P＜0.05）。결론노년중증심력쇠갈환자재접수급진내과상규치료기출상구복패사탄경록새진화미탁락이，료효현저，가유효개선환자심공능，안전성교고，심력쇠갈복발솔화사망솔교저，치득림상추엄응용。
ObjectiveTo explore the diagnosis and treatment of elderly patients with severe heart failure in the emergency medical and analyze the clinical effect.Method90 elderly patients with severe heart failure treated in our hospital from January 2012 to June 2013 were selected as the research objects, according to the treatment order number divided into observation group and control group, 45 cases in each group. Control group received only routine medical emergency treatment, observation group were treated with irbesartan hydrochlorothiazide and metoprolol based on control group, all of the patients were followed up for 1 year. The clinical efifcacy, the changes of left ventricular ejection fraction (LVEF) and B-type natriuretic peptide (BNP) before and after treatment, adverse reactions, disease recurrence and mortality were compared between the two groups.ResultThe total effective rate in control group was 95.56% (43/45), observation group was 77.78% (35/45), the difference was statistically significant (P<0.05). Before treatment, there were no significant differences of LVEF and BNP levels between the two groups (P>0.05). After treatment, the level of LVEF was increased signiifcantly in observation group, the two groups of BNP were signiifcantly reduced, LVEF and BNP changes were signiifcantly greater in observation group than control group (P<0.05). There were no obvious adverse reactions in two groups, heart failure recurrence rate of observation group was 4.44%, mortality rate was 2.22%, heart failure recurrence rate of control group was 26.67%, mortality rate was 22.22%, the differences were statistically signiifcant (P<0.05).ConclusionElderly patients with severe heart failure in an emergency department on the basis of conventional treatment of oral irbesartan hydrochlorothiazide and metoprolol, has obvious curative effect, can effectively improve the heart function of patients, high safety, heart failure recurrence rate and mortality rate are low, worthy of clinical application.
