目的 研究左西孟旦联合美托洛尔对老年慢性心力衰竭患者心功能、N端脑钠肽前体水平和心室重构的影响。方法 选取2015年1月-2017年12月新疆兵团第一师医院诊治的老年慢性心力衰竭患者81例，按治疗方法分为对照组41例、观察组40例。对照组口服美托洛尔片治疗，观察组联合给予左西孟旦注射液治疗。比较两组的治疗有效率，心功能指标以及N端脑钠肽前体水平。结果 观察组老年慢性心力衰竭患者的总有效率为92.50%，明显高于对照组的75.61%，差异有统计学意义（P<0.05）。治疗后两组患者的左心室射血分数、左心室舒张末期内径、左心室后壁厚度均显著改善，同组治疗前后比较差异有统计学意义（P<0.05）；且观察组更明显，组间比较差异有统计学意义（P<0.05）。两组治疗后的N端脑钠肽前体水平均明显降低，同组治疗前后比较差异有统计学意义（P<0.05）；且观察组更为明显，组间比较差异有统计学意义（P<0.05）。结论 左西孟旦联合美托洛尔可以有效改善老年慢性心力衰竭患者的心功能，降低N端脑钠肽前体水平，抑制心室重构，且具有较高的安全性。

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

新疆市科技厅项目（2016YL08）