目的 探讨氨氯地平联合美托洛尔治疗冠心病患者的临床疗效。方法 选取2019年1月-2020年6月在商丘市第四人民医院就诊的冠心病患者142例为研究对象，随机分为对照组和治疗组，每组各71例。对照组患者口服酒石酸美托洛尔片，1片/次，2次/d。治疗组在对照组的基础上口服苯磺酸氨氯地平片，1片/次，1次/d。两组患者连续治疗5周。观察两组患者临床疗效，同时比较治疗前后两组患者低密度脂蛋白胆固醇（LDL-C）和单核细胞趋化蛋白-1（MCP-1）水平，心率（HR）、左心室收缩末期内径（LVESD）、左心室舒张末期内径（LVEDD）和左心室射血分数（LVEF）心功能水平，及炎症因子白细胞介素-6（IL-6）、超敏C反应蛋白（hs-CRP）和肿瘤坏死因子-α（TNF-α）水平。结果 治疗后，对照组临床总有效率为76.06%，显著低于治疗组的94.37%，两组比较差异有统计学意义（P<0.05）。治疗后，两组患者LDL-C、MCP-1水平均明显低于治疗前（P<0.05），且治疗组LDL-C、MCP-1水平均低于对照组（P<0.05）。治疗后，两组患者HR、LVESD、LVEDD水平均低于治疗前（P<0.05），但是LVEF水平均高于治疗前（P<0.05），且治疗组HR、LVESD、LVEDD和LVEF水平均好于对照组（P<0.05）。治疗后，两组患者IL-6、hs-CRP、TNF-α水平均显著低于治疗前（P<0.05），且治疗组IL-6、hs-CRP、TNF-α水平明显低于对照组（P<0.05）。结论 氨氯地平联合美托洛尔可有效提高冠心病的治疗效果，降低患者的LDL-C、MCP-1、IL-6、hs-CRP、TNF-α水平，改善患者心功能，抑制机体炎症反应。

Objective To investigate the therapeutic effect of amlodipine combined with metoprolol in treatment of coronary heart disease. Methods Patients (142 cases) with coronary heart disease in the Fourth People's Hospital of Shangqiu from January 2019 to June 2020 were randomly divided into control and treatment groups, and each group had 71 cases. Patients in the control group were po administered with Metoprolol Tartrate Tablets, 1 tablet/time, twice daily. Patients in the treatment group were po administered with Amlodipine Besilate Tablets on the basis of the control group, 1 tablet/time, once daily. Patients in two groups were treated for 5 weeks. After treatment, the clinical efficacy was evaluated, and the levels of LDL-C and MCP-1, the cardiac function levels of HR, LVESD, LVEDD, and LVEF, and the inflammatory factors levels of IL-6, hs-CRP, and TNF-α in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 76.06%, which was significantly lower than 94.37% in the treatment group, and there were differences between two groups (P<0.05). After treatment, the levels of LDL-C and MCP-1 in two groups were significantly decreased (P<0.05), and which in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, the HR, LVESD, and LVEDD levels in two groups were significantly decreased (P<0.05), but the LVEF levels in two groups were significantly increased (P<0.05), and the cardiac function levels in the treatment group were significantly better than those in the control group (P<0.05). After treatment, the inflammatory factors levels of IL-6, hs-CRP, and TNF-α in two groups were significantly decreased (P<0.05), and which in the treatment group were significantly lower than those in the control group (P<0.05). Conclusion Amlodipine combined with metoprolol in treatment of coronary heart disease can effectively improve the therapeutic effect, reduce the levels of LDL-C, MCP-1, IL-6, hs-CRP and TNF-α, and inhibit the inflammatory reaction.

R972

国家科技支撑计划课题（2013BAI09B01）