内科

目的探讨酒石酸美托洛尔联合脑心通治疗冠心病合并高血压患者的临床疗效。方法选取2017年2月至2019年3月我院收治的冠心病合并高血压患者92例为研究对象，按照患者就诊先后顺序分为观察组和对照组，每组46例。对照组患者给予酒石酸美托洛尔治疗，观察组患者给予酒石酸美托洛尔联合脑心通治疗，疗程8周。比较两组患者的临床疗效；比较两组患者治疗前后的血压、心功能、内皮功能；比较治疗期间两组患者的心血管不良事件发生情况。结果观察组患者的治疗总有效率（93.5%）高于对照组（78.3%），差异有统计学意义（P＜0.05）。治疗前，两组患者的收缩压、舒张压比较差异无统计学意义（P＞0.05）；治疗8周后，观察组患者的收缩压、舒张压低于对照组，差异有统计学意义（P＜0.05）。治疗前，两组患者的心功能指标水平比较差异无统计学意义（P＞0.05）；治疗8周后，观察组患者的左室收缩末期内径、左室舒张末期内径小于对照组，左室射血分数高于对照组，差异有统计学意义（P＜0.05）。治疗前，两组患者的血浆内皮素-1（ET-1）、一氧化氮（NO）水平比较差异无统计学意义（P＞0.05）；治疗8周后，观察组患者的ET-1水平低于对照组，NO水平高于对照组，差异有统计学意义（P＜0.05）。治疗期间两组患者的心血管不良事件发生率比较差异无统计学意义（P＞0.05）。结论酒石酸美托洛尔联合脑心通治疗冠心病合并高血压患者临床疗效显著，可明显降低血压，改善心功能和血管内皮功能，但不会增加心血管不良事件的发生。

ObjectiveTo explore the clinical efficacy of metoprolol tartrate combined with Naoxintong in the treatment of patients with coronary heart disease combined with hypertension. MethodsA total of 92 patients with coronary heart disease combined with hypertension who were admitted to our hospital from February 2017 to March 2019 were selected as the research objects, and they were divided into observation group and control group according to the sequence of their visits, with 46 cases in each group. The control group was treated with metoprolol tartrate, whereas the observation group was treated with metoprolol tartrate combined with Naoxintong, for an eight-week treatment course. The clinical efficacy, the blood pressure, cardiac function, and endothelial function before and after treatment, as well as the occurrence of adverse cardiovascular events during the treatment, were compared between the two groups. ResultsThe total effective rate of treatment in the observation group (93.5%) was higher than that in the control group (78.3%), and the difference was statistically significant (P＜0.05). There were no statistically significant differences in systolic and diastolic blood pressures between the two groups before treatment (P＞0.05). The systolic and diastolic blood pressures of the observation group were lower than those of the control group after 8 weeks of treatment, and the differences were statistically significant (P＜0.05). There were no statistically significant differences in the levels of cardiac function indexes between the two groups before treatment (P＞0.05); after 8 weeks of treatment, the left ventricular end-systolic diameter and left ventricular end-diastolic diameter of the observation group were smaller than those of the control group, whereas the left ventricular ejection fraction was higher than that of the control group, and the differences were statistically significant (P＜0.05). There were no statistically significant differences in the levels of Endothelin-1 (ET-1) and nitric oxide (NO) between the two groups before treatment (P＞0.05); after 8 weeks of treatment, the ET-1 level of the observation group was lower than that of the control group, and the NO level was higher than that of the control group, with statistically significant differences (P＜0.05). There was no statistically significant difference in the incidence of cardiovascular adverse events between the two groups during the treatment period (P＞0.05). ConclusionMetoprolol tartrate combined with Naoxintong has a significantly clinical effect for patients with coronary heart disease combined with hypertension, which can significantly decrease blood pressure, improve heart function and vascular endothelial function, but it will not increase the incidence of cardiovascular adverse events.