比索洛尔联合尼可地尔治疗老年冠状动脉粥样硬化性心脏病心力衰竭患者的效果观察OA

Objective To investigate the curative effects of bisoprolol combined with nicorandil in the treatment of older patients with coronary heart disease(CHD)complicated with heart failure(HF).Methods 162 older patients with CHD and HF who were admitted to the Harbin Ches Hospital from April 2022 to December 2024 were divided into control A group(bisoprolol),control B group(nicorandil)and experimental group(bisoprolol+nicorandil)according to a random number table method,with 54 cases in each group.The treatment course was 4 weeks.The curative effects,coagulation function,oxidative stress and inflammatory markers,cardiac function,occurrence of adverse reactions,as well as the incidence of major cardiovascular events(MACE)during the 6-month follow-up period were compared among the three groups.Results After four weeks of treatment,the curative effect of the experimental group was better than that of the control A group(χ2=4.696,P=0.030)and the control B group(χ2=6.667,P=0.010).There were significant differences in difference values of D-dimer,antithrombin,fibrinogen,malondialdehyde,lipid peroxide,high-sensitivity C-reactive protein and tumor necrosis factor-α before and after treatment among the three groups(F=121.437,213.414,66.163,187.853,189.188,440.408,255.070;P＜0.05),and the decreased amplitude in the experimental group was greater than that in the control A group(q=17.802,23.958,14.694,24.221,23.504,35.880,28.279;P＜0.05)and the control B group(q=20.154,26.462,13.393,23.226,24.131,36.800,27.001;P＜0.05).There were significant differences in difference values of left ventricular ejection fraction,cardiac output,stroke volume and cardiac index before and after treatment among the three groups(F=314.521,93.188,218.731,431.229;P＜0.05),and the increased amplitude in the experimental group was greater than that in the control A group(q=31.156,15.693,24.592,35.074;P＜0.05)and the control B group(q=30.259,17.587,26.530,36.799;P＜0.05).There was no significant difference in the total incidence of adverse reactions among the three groups(χ2=2.530,P=0.112＞0.05).The total incidence of MACE in the experimental group was lower than that in the control A group(χ2=5.173,P=0.023)and the control B group(χ2=7.153,P=0.007).Conclusion The clinical curative effect of bisoprolol tablet combined with nicorandil tablet is good in elderly patients with CHD and HF.It can effectively alleviate hypercoagulability,reduce oxidative stress and inflammatory responses,promote the recovery of cardiac function,and has good safety.