丹参颗粒联合美托洛尔治疗合并冠心病射血分数保留心力衰竭老年患者的临床疗效OACSTPCD

Objective To explore the therapeutic effect of Danshen Granules combined with metoprolol in the treatment of eld-erly patients with preserved ejection fraction heart failure complicated with coronary heart disease,and to analyze its influence on in-flammatory factors and the levels of NT proBNP and MMP-9.Methods A retrospective analysis was conducted on the clinical data of 274 elderly patients with preserved ejection fraction heart failure and coronary heart disease admitted to the 73rd Group Military Hospi-tal of PLA Arny from December 2019 to December 2022.The patients were divided into control group(n=111)and observation group(n=163)according to drug use.The control group was treated with metoprolol,while the observation group was treated with a combi-nation of metoprolol and Danshen granules.The clinical efficacy,cardiac function[left ventricular end systolic diameter(LVESD),left ventricular ejection fraction(LVEF),left ventricular end diastolic diameter(LVEDD)],vascular endothelial function[endothelin 1(ET-1),nitric oxide(NO)],inflammatory factors[hypersensitive C-reactive protein(hs CRP),soluble intercellular adhesion molecule-1(sICAM-1)and interleukin-6(IL-6)],serum levels of NT-proBNP and MMP-9,and occurrence of adverse reactions were compared between two groups.Results After treatment,the clinical effective rate of the observation group was higher than that of the control group(93.87%vs.81.98%)(P<0.05).After treatment,the cardiac function of the two groups was improved.The LVEDD,LVEF and LVESD in the observation group were better than those in the control group[(47.36±6.43)mm vs.(50.86±4.27)mm;(59.93±4.73)%vs.(56.38±4.21)%;(29.46±4.13)mm vs.(33.56±4.68)mm;P<0.05].After treatment,the vascular endothelial function of the two groups was improved.The levels of ET-1 and NO in the observation group were better than those in the control group[(51.46±7.75)ng/L vs.(59.69±6.73)ng/L;(101.89±11.73)μmol/L vs.(90.71±10.83)μmol/L;P<0.05].After treatment,the levels of inflammatory factors in the two groups were improved.The levels of hs-CRP,sI-CAM-1 and IL-6 in the observation group were better than those in the control group[(7.27±0.83)mg/L vs.(9.37±0.95)mg/L;(194.68±20.01)ng/ml vs.(223.64±28.79)ng/ml;(27.62±2.93)pg/ml vs.(32.60±3.76)pg/ml;P<0.05].After treatment,the levels of NT-proBNP and MMP-9 in the two groups were improved.The levels of NT-proBNP and MMP-9 in the observation group were better than those in the control group[(324.19±173.06)ng/L vs.(395.69±186.79)ng/L;(146.72±15.85)μg/L vs.(163.76±16.14)μg/L;P<0.05].There was no statistical difference in the occurrence of adverse reactions between two groups(P<0.05).Conclusions The combination of Danshen granules and metoprolol has a signifi-cant therapeutic effect on elderly patients with preserved ejection fraction heart failure complicated with coronary heart disease,which can improve inflammation and reduce serum levels of NT proBNP and MMP-9.