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Objective To observe the effect of metoprolol combined with trimetazidine on coronary heart disease with chronic congestive heart failure ,and its effects on myocardial structure ,plasma brain natriuretic peptide (BNP) and matrix metalloproteinase－9 (MMP－9).Methods From January 2016 to November 2017,160 coronary heart disease patients with chronic congestive heart failure in the First Peopleˊs Hospital of Wenling were randomly divided into treatment group (78 cases)and control group (77 cases)through random number table method.The control group was given conventional anti－heart failure treatment.The treatment group was treated with metoprolol and trimetazidine. After 3 months of treatment,left ventricular end－diastolic volume (LVEDV), left ventricular end －systolic volume (LVESV),LVEF,BNP and changes in MMP －9 were compared.Results The total effective rate of the treatment group was 90.36%,which was significantly higher than 77.92%of the control group (χ2 ＝5.024,P＜0.05).There were no statistically significant differences in LVESV and LVEDV between the two groups before and after treatment (t＝0.07,P＝0.47;t＝0.75,P＝0.22;t＝0.90,P＝0.18;t＝1.24,P＝0.10).Compared with before treatment ,the LVEF change in the control group had no statistically significant difference ( P＞0.05),the LVEF of the treatment group was increased [(41.38 ±9.26)% vs.(46.31 ±10.8)%] ( t ＝－3.15,P＝0.001).After treatment,the LVESV between the treatment group and control group had statistically significant difference [(124.54 ±16.57) mL vs.(106.36 ±16.44)mL](t＝7.16,P＜0.05).The BNP level was decreased in the treatment group after treatment [(4 036.39 ±696.24)ng／L vs.(3 621.78 ±732.57) ng／L] ( t＝3.73,P＜0.05),while the BNP level had no statistically significant change in the control group ( t＝1.47,P＝0.07).the MMP－9 level in the treatment group was lower than that before treatment [(396.21 ±97.56)ng／mL vs.(345.11 ±86.25)ng／mL](t＝3.57,P＜0.05), while the MMP－9 level in the control group had no statistically significant change (t＝1.06,P＝0.15).The MMP－9 and BNP levels decreased more significantly in the treatment group than those in the control group (t＝3.73,3.57,all P＜0.05).Conclusion Metoprolol combined with trimetazidine in the treatment of patients with chronic heart failure can significantly alleviate clinical symptoms ,reduce the expression level of MMP －9,and is safe for clinical use. Therefore,it is recommended use in clinical.
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Objective@#To observe the effect of metoprolol combined with trimetazidine on coronary heart disease with chronic congestive heart failure, and its effects on myocardial structure, plasma brain natriuretic peptide (BNP) and matrix metalloproteinase-9 (MMP-9).@*Methods@#From January 2016 to November 2017, 160 coronary heart disease patients with chronic congestive heart failure in the First People's Hospital of Wenling were randomly divided into treatment group (78 cases)and control group (77 cases)through random number table method.The control group was given conventional anti-heart failure treatment.The treatment group was treated with metoprolol and trimetazidine.After 3 months of treatment, left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume(LVESV), LVEF, BNP and changes in MMP-9 were compared.@*Results@#The total effective rate of the treatment group was 90.36%, which was significantly higher than 77.92% of the control group (χ2=5.024, P<0.05). There were no statistically significant differences in LVESV and LVEDV between the two groups before and after treatment (t=0.07, P=0.47; t=0.75, P=0.22; t=0.90, P=0.18; t=1.24, P=0.10). Compared with before treatment, the LVEF change in the control group had no statistically significant difference(P>0.05), the LVEF of the treatment group was increased[(41.38±9.26)% vs.(46.31±10.8)%] (t=-3.15, P=0.001). After treatment, the LVESV between the treatment group and control group had statistically significant difference[(124.54±16.57)mL vs.(106.36±16.44)mL](t=7.16, P<0.05). The BNP level was decreased in the treatment group after treatment[(4 036.39±696.24)ng/L vs.(3 621.78±732.57)ng/L] (t=3.73, P<0.05), while the BNP level had no statistically significant change in the control group (t=1.47, P=0.07). the MMP-9 level in the treatment group was lower than that before treatment[(396.21±97.56)ng/mL vs.(345.11±86.25)ng/mL](t=3.57, P<0.05), while the MMP-9 level in the control group had no statistically significant change (t=1.06, P=0.15). The MMP-9 and BNP levels decreased more significantly in the treatment group than those in the control group (t=3.73, 3.57, all P<0.05).@*Conclusion@#Metoprolol combined with trimetazidine in the treatment of patients with chronic heart failure can significantly alleviate clinical symptoms, reduce the expression level of MMP-9, and is safe for clinical use.Therefore, it is recommended use in clinical.
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Objective To investigate the association between β2-adrenergic receptor gene polymorphism and coronary atherosclerotic heart disease, and to provide reference for clinical disease prevention and treatment.MethodsThe clinical data of 200 patients with coronary atherosclerotic heart disease confirmed by coronary angiography were selected and included in the study group, and 200 healthy subjects without coronary atherosclerotic heart disease group.The polymorphism of β2 adrenergic receptor gene was detected and the frequency of each gene was analyzed.ResultsThe genotype frequencies of β2-adrenergic receptor gene were in accordance with Hardy-Weinberg equilibrium, the difference was not statistically significant.According to dominant genetic model, the frequency of AA+AG was 46.0% vs 58.0% lower than that of the control group, and had statistical significance, The genotype frequency of GG genotype in study group was significantly lower than that in control group 14.0% vs 26.0%, χ2=26.20, P=0.00.The frequency of GG genotype in study group was significantly higher than that in control group 54.0% vs 42.0%, χ2=5.76, P=0.01.The frequency of A gene was 38.0% compared with 44.0% in control group, χ2=1.48, P=0.22;the frequency of AA gene in study group was 30.0%, and the frequency of gene A was 38.0%, compared with 56.0% Compared with 32.0% in the control group, χ2=0.18, P=0.66.ConclusionThe A/G polymorphism of β2-adrenergic receptor gene is closely related to the clinical pathogenesis of coronary atherosclerotic heart disease, and the A allele may be a protective factor in patients with coronary atherosclerotic heart disease.