目的 探討輔酶Q10片聯(lián)合美托洛爾片治療慢性心力衰竭的臨床療效。方法 收集2015年9月—2016年9月在南陽市中心醫(yī)院進(jìn)行治療的慢性心力衰竭患者86例，隨機(jī)分為對照組和治療組，每組各43例。對照組患者口服酒石酸美托洛爾片，初始劑量6.25 mg/次，2次/d，可耐受情況下，每隔1周增加6.25 mg，8周內(nèi)增加至50 mg/d，2次/d。治療組在對照組的基礎(chǔ)上口服輔酶Q10片，1片/次，3次/d。兩組患者均連續(xù)治療12周。評價兩組臨床療效，同時比較兩組治療前后心功能指標(biāo)和血清細(xì)胞因子水平。結(jié)果 治療后，對照組的總有效率為72.09%，顯著低于治療組的90.70%，兩組比較差異有統(tǒng)計學(xué)意義（P < 0.05）。治療后，兩組患者NYHA分級、左心室舒張末期內(nèi)徑（LVEDD）和左心室收縮期末內(nèi)徑（LVESD）均比同組治療前明顯降低，左心室射血分?jǐn)?shù)（LVEE）則顯著升高，同組比較差異具有統(tǒng)計學(xué)意義（P < 0.05）；且治療組心功能指標(biāo)優(yōu)于對照組，兩組比較差異具有統(tǒng)計學(xué)意義（P < 0.05）。治療后，兩組患者血清白細(xì)胞介素-6（IL-6）、IL-12、腫瘤壞死因子-α（TNF-α）、腦鈉肽（BNP）水平均低于治療前，同組比較差異具有統(tǒng)計學(xué)意義（P < 0.05）；且治療后治療組患者降低水平優(yōu)于對照組，兩組比較差異具有統(tǒng)計學(xué)意義（P < 0.05）。結(jié)論 輔酶Q10聯(lián)合美托洛爾治療慢性心力衰竭效果顯著，可明顯改善患者左心室功能，并降低機(jī)體炎癥反應(yīng)，具有一定的臨床推廣應(yīng)用價值。

Objective To investigate the clinical efficacy of Coenzyme Q10 Tablets combined with metoprolol in treatment of chronic heart failure. Methods Patients (43 cases) with chronic heart failure in Nanyang City Central Hospital from September 2015 to September 2016 were randomly divided into control and treatment groups, and each group had 43 cases. Patients in the control group were po administered with Metoprolol Tartrate Tablets, the first dosage was 6.25 mg/time, twice daily, which was increased by 6.25 mg per week based on tolerable condition and to 50 mg/d within eight weeks, twice daily. Patients in the treatment group were po administered with Coenzyme Q10 Tablets on the basis of the control group, 1 tablet/time, once daily. Patients in two groups were treated for 12 weeks. After treatment, the clinical efficacy was evaluated, and the cardiac function indexes, serum cytokines in two groups were compared. Results After treatment, the clinical efficacy in the control group was 72.09%, which was significantly lower than 90.70% in the treatment group, with significant difference between two groups (P < 0.05). After treatment, the NYHA grade, LVEDD, and VESD in two groupssignificantly decreased, LVEE significantly increased, and the difference was statistically significant in the same group (P < 0.05). And these cardiac function indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P < 0.05). After treatment, the IL-6, IL-12, TNF-α, and BNP levels in two groups significantly decreased, and there was difference in the same groups (P < 0.05). And these levels in the treatment group were significantly better than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Coenzyme Q10 Tablets combined with metoprolol has remarkable effect in treatment of chronic heart failure, can significantly improve left ventricular function, and reduce the inflammatory response, which has a certain clinical application value.