Objective To analyze the clinical treatment of elderly patients with severe heart fallure patients in the Department of Internal Medicine ,and to provide the reference for the clinical treatment of the disease .Meth‐ods From 2012 January to 2014 June in our hospital were treated patients with senile severe heart fallure 120 ca‐ses treatment ,comparative analysis .Treatment methods are as follows :120 cases were randomly divided into two groups ,the observation group of 60 cases and control cases 60 ,groups of patients using conventional heart fallure treatment method were given sodium nitroprusside ,cardiotonic ,diuretic and other drugs for conventional treat‐ment ,the observation group in the conventional treatment based on the given to patients ,add oral irbesartan and hydrochlorothiazide combination metoprolol treatment were compared between the two groups of patients ,receiv‐ing treatment for half a year and one year after the series ,cardiac function ,left ventricular ejection fraction ,B‐type natriuretic peptide and the improvement of 1 years of follow‐up ,times of hospitalization ,days of hospitaliza‐tion and mortality in patients with• Results To observe the heart function series ,left ventricular ejection fraction and B‐type natriuretic peptide index and compare to the control group ,the patients in the treatment group ,the difference was not statistically significant ( P > 0•05) ;three indicators of two groups of patients were improved significantly compared with before treatment ,the observation group significantly better than the control group , the two groups comparison ,the differences were statistically significant ( P < 0•05) ;two patients at 1 year fol‐low‐up ,to observe the length of hospital stay and mortality were significantly lower than the control group ,times of hospitalization ,patients ,comparing the two groups ,with statistically significant difference ( P < 0•05) .Con‐clusion The treatment of elderly severe heart fallure based on conventional symptomatic ,early use of irbesartan and hydrochlorothiazide combined with metoprolol medication assisted treatment ,can improve the treatment effect and improve the prognosis of the patients effectively.%目的：探讨分析内科老年重症心力衰竭患者临床治疗方案，为该病的临床治疗策略制定提供参考。方法收集2012年1月至2014年6月我院收治的老年重症心力衰竭患者120例，随机分成2组，观察组60例和对照组60例，对照组患者给予硝普钠、强心剂、利尿剂等进行常规治疗，观察组在常规治疗的基础上，加服厄贝沙坦氢氯噻嗪联合美托洛尔治疗，观察比较2组患者接受治疗半年和1年后，心功能分级、左心室射血分数、B型脑钠肽改善情况以及1年随访期间，患者的住院次数、住院天数和病死率。结果观察组患者治疗前心功能分级、左心室射血分数和 B 型脑钠肽指数和对照组比较，差异没有统计学意义（ P ＞0•05）；治疗后2组患者3项指标均较治疗前有明显改善，观察组改善情况明显优于对照组，2组比较差异均有统计学意义（ P ＜0•05）；2组患者在1年随访期内，观察组患者住院次数、住院天数和病死率均明显低于对照组，2组比较差异有统计学意义（ P＜0•05）。结论在常规对症治疗老年重症心力衰竭基础上，早期使用厄贝沙坦氢氯噻嗪联合美托洛尔药物辅助治疗，能有效地提高治疗效果和改善患者预后。
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