Objective To discuss the clinical efficacy of metoprolol combined with simvastatin on CRP and BNP lev-els in the treatment of elderly patients with unstable angina pectoris (UAP).Methods From April 2014 to May 2015, 118 cases of UAP patients in Shanxi Nuclear Industry No.215 Hospital were selected as the research object, and according to the random number table method, they were divided into observation group with 59 cases and control group with 59 cases.Treat-ment of two groups of patients after admission were given conventional oxygen, ECG monitoring, aspirin, low molecular hepa-rin sodium gel, nitrate isosorbide ester;the control group based on the conventional treatment, also combined application of metoprolol, initial dose each 12.5 mg orally, twice daily, until 25 mg, 2 times daily; observation group besides the control group treatment, also received simvastatin tablets with 20 mg /time, 1 time /d, bedtime meal service.The course of treat-ment in 2 groups was 3 months.The clinical efficacy of the 2 groups, myocardial enzyme spectrum, blood lipids, CRP, BNP levels, adverse events and cardiovascular events were observed before and after the treatment.Results After treatment, the observation groups’ total effective rate was significantly higher than that of control group (98.3% vs.84.7%,χ2 =6.993, P <0.05);2 group patients’ LDH, CK-MB, blood lipid, CRP and BNP were significantly improved compared with those before treatment (P <0.05);in the observation group, the degree of improvement were better than those of the control group ( P <0.05);observation groups’ angina attack frequency was significantly lower than that of control group ( P <0.05), and alanine aminotransferase increased, acute myocardial infarction and sudden cardiac death did not show significant differ-ence ( P >0.05).Conclusion Metoprolol combined with simvastatin in the treatment of elderly patients with unstable angi-na pectoris is effective and safe, it can significantly reduce the levels of CRP and BNP, it is worthy of clinical promotion.%目的：探讨美托洛尔联合辛伐他汀治疗老年不稳定型心绞痛（ UAP）患者的临床疗效及对C反应蛋白（ CRP）、脑钠肽（ BNP）水平的影响。方法选取2014年4月—2015年5月于陕西省核工业二一五医院住院治疗的UAP患者118例为研究对象，按随机数字表法分为观察组59例和对照组59例。2组患者入院后均给予常规吸氧、心电监护，应用阿司匹林、低分子肝素钠凝胶、硝酸异山梨酯等治疗；对照组在常规治疗基础上联合应用美托洛尔片，初始剂量每次12挝．5 mg口服，2次／d，直至25 mg／次，2次／d；观察组在对照组基础上给予辛伐他汀片20 mg／次，1次／d，睡前顿服。2组患者疗程均为3个月。观察2组患者临床疗效，治疗前后心肌酶谱、血脂、CRP、BNP水平、不良反应及心血管事件发生情况。结果治疗后，观察组总有效率明显高于对照组（98．3％ vs．84．7％，χ2＝6．993， P ＜0．05）。2组患者LDH、CK-MB、血脂、CRP、BNP水平较治疗前明显改善（ P ＜0．05），且观察组改善程度均优于对照组（ P ＜0．05）。观察组心绞痛发作次数明显低于对照组（ P ＜0．05），而谷氨酸氨基转移酶升高、急性心肌梗死及心源性猝死发生率差异无统计学意义（ P ＞0．05）。结论美托洛尔联合辛伐他汀治疗老年不稳定型心绞痛患者疗效确切，安全性好，能显著降低CRP、BNP水平，值得临床推广。
展开▼
