Efficacy evaluation according to the combination of enalapril and metoprolol in patients with left ventricular diastolic dysfunction for medical role. Methods: 63 hospitalized patients with acute exacerbation of chronic congestive heart failure (cardiac function in NYHA class Ⅲ-Ⅳ) were divided into a control group (31 cases) and an observation group (32 cases). The observation group, on the basis of the control group treatment, received cyclic adenosine monophosphate injection at 40~60mg via intravenous infusion once daily for 10 days as a course of treatment. Clinical efficacy was compared between the two groups. Results: After 10 days of treatment with cyclic adenosine monophosphate, the clinical improvement total efficiency in the observation group was 87.5%, while the total efficiency in the control group was 74.2%. There was a significant difference in clinical efficacy between the two groups (P < 0.05). Exclusion criteria included patients with severe infection, low blood pressure, severe liver and kidney dysfunction, and those allergic to the drug.
1.2 Treatment: The control group received conventional treatment according to CHF with acute exacerbation, including digitalis, diuretics, ACE inhibitors, nitrates, and other drug treatments. On the basis of the control group treatment plan, the observation group was given 5% dextrose injection or 0.9% sodium chloride injection (250mL) containing 40~60mg cyclic adenosine monophosphate via intravenous infusion once daily for 10 days as a course of treatment. Both groups could temporarily add morphine, furosemide, deacetylase lanatoside, two hydroxypropyl theophylline, antibiotics, or supplemental electrolytes based on the condition. Blood pressure, changes in heart rate and clinical symptoms, adverse drug reactions, and patient treatment tolerance and compliance were observed daily.
1.3 Efficacy standards: According to the NYHA cardiac function classification standard, after treatment, the classification changes were recorded. Markedly effective: Cardiac function improved by two grades or reached normal cardiac function, with disappearance of symptoms and signs. Effective: Cardiac function improved by one grade but did not reach normal cardiac function, with improvement in symptoms, signs, and various tests. Ineffective: No significant changes or deterioration in cardiac function.
1.4 Statistical analysis: Data were expressed as percentages and ±s, x, and t-tests were performed, with P < 0.05 indicating statistical significance.
2 Results: As shown in Table 1, the effects before and after treatment in the observation group treated with cAMP plus conventional treatment and the control group treated conventionally in CHF patients with acute exacerbation are presented. Note: Comparison of the total effective rate, P < 0.05. The observation group showed clinical improvement with a total efficiency of 87.5% after 10 days of cyclophosphamide adenosine treatment, compared to the control group's total efficiency of 74.2%, indicating a significant difference in clinical efficacy (P < 0.05), as shown in Table 1. No significant adverse drug reactions were found in either group during treatment, and treatment was well-tolerated.
3 Discussion: Chronic heart failure is extremely common among critically ill patients in clinical practice and is often a major complication of all different causes of structural heart disease. In recent years, although some important cardiovascular diseases (coronary heart disease, hypertension, and valvular disease) have seen controlled morbidity and mortality, the incidence of heart failure has been increasing. It is necessary to treat the cause in CHF patients with acute exacerbation; reduce cardiac stress; increase cardiac output; regulate excessively activated neurohumoral factors; and improve ventricular function comprehensively. Cyclic adenosine monophosphate (cAMP) can improve myocardial ischemia, enhance coronary expansion and myocardial contractility, and increase cardiac output. It can be used as an adjuvant treatment for angina pectoris and acute myocardial infarction, with a shorter duration of action. This study suggests that for CHF patients with acute exacerbation...