目的 探究小劑量阿司匹林聯(lián)合美托洛爾治療老年慢性心衰的臨床療效。方法 選取2011年7月—2013年7月總后勤部廣州離職干部休養(yǎng)所門(mén)診部就診的老年慢性心衰患者84例，依據(jù)分層隨機(jī)分組方法將患者分為治療組與對(duì)照組，每組42例，治療組口服小劑量阿司匹林腸溶片，75 mg/次，1次/d；同時(shí)，口服酒石酸美托洛爾6.25 mg/次，2次/d，配合常規(guī)抗心衰治療。對(duì)照組僅予以常規(guī)抗心衰治療，兩組均治療4周。觀察兩組患者治療前后血漿P-選擇素、血管性假性血友病因子、D-二聚體水平、腦利鈉肽水平及心功能改善情況。結(jié)果 治療4周后，兩組患者血漿P-選擇素、血管性假性血友病因子和D-二聚體水平均較治療前有所下降，治療前后差異均有統(tǒng)計(jì)學(xué)意義（P＜0.05）；治療后治療組患者的血漿P-選擇素、血管性假性血友病因子和D-二聚體水平均低于對(duì)照組，兩組差異有統(tǒng)計(jì)學(xué)意義（P＜0.05）。治療1、2、3、4周后，兩組患者腦利鈉肽水平均較治療前有所下降，治療前后差異均有統(tǒng)計(jì)學(xué)意義（P＜0.05）。治療后，治療組患者的腦利鈉肽水平均低于同期對(duì)照組患者，兩組差異有統(tǒng)計(jì)學(xué)意義（P＜0.05）。治療后，治療組和對(duì)照組的總有效率分別為85.71%、57.14%，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P＜0.05）。結(jié)論 小劑量阿司匹林聯(lián)合美托洛爾配合標(biāo)準(zhǔn)抗心衰治療對(duì)于老年慢性心衰患者具有較好的抗血栓形成和促進(jìn)患者心功能恢復(fù)的作用，建議臨床推廣使用。

Objective To explore the clinical efficacy of low-dose aspirin combined with metoprolol on elderly patients with chronic heart failure. Methods Eighty-four cases of elderly patients with chronic heart failure who came to Clinic Department of Resthome for Retired Veterans in Guangzhou from July 2011 to July 2013 for treatment were selected as the sample. The patients were divided into treatment group and control group according to stratified randomization method, and there are 42 cases in each group. The treatment group was po administered with low-dose aspirin enteric-coated metformin hydrochloride, once 75 mg, once daily, and combined with Metoprolol Tablets, once 6.25 mg, twice daily, along with conventional therapy, while the patients in the control group were given conventional therapy only. Both groups were treated for 4 weeks. The plasma P-selectin, von Willebrand factor, D-dimer, brain natriuretic peptide, and cardiac function improvement of the two groups were compared before and 4 weeks after the therapy.

國(guó)家自然科學(xué)基金資助項(xiàng)目（81070196）