美托洛尔对慢性阻塞性肺疾病患者肺功能及预后的影响

Effect of metoprolol on pulmonary function and prognosis of patients with chronic obstructive pulmonary disease

目的探讨美托洛尔在治疗慢性阻塞性肺疾病(慢阻肺)患者中的应用价值及安全性分析。方法回顾性分析2014年至2015年我院收治的慢阻肺患者,按照是否使用美托洛尔,分为治疗组和对照组。随访患者临床参数变化以及生存期。结果美托洛尔治疗前两组患者心率、LVEDD及LVEF等临床参数均无统计学差异;治疗后,对照组LVEDD显著下降,差异有统计学意义(P<0.05),心率有下降趋势,但差异无统计学意义(均P>0.05),而LVEF百分比呈上升趋势(P>0.05);治疗组心率、肺动脉压和LVEDD均明显下降,差异均有统计学意义(均P<0.05),而FEV1和LVEF百分比呈上升趋势,差异有统计学意义(P<0.05)。治疗前两组患者6min步行距离无统计学差异,治疗3个月后,治疗组和对照组患者步行距离均明显远于治疗前(均P<0.05);美托洛尔治疗6个月后,治疗组6 min步行距离明显大于对照组(P<0.05)。美托洛尔治疗可以上调患者血氧饱和度,但是治疗前后,以及治疗后对照组和观察组相比,差异均无统计学意义(均P>0.05);美托洛尔治疗可以有效降低收缩压和心率,差异均具有统计学意义(均P<0.05)。美托洛尔治疗可显著提高患者生活质量。结论美托洛尔可显著改善心功能,提高慢阻肺患者生活质量,是一种可应用于慢性心力衰竭并发慢阻肺患者的临床治疗药物。

Objective To explore the curative value and security of metoprolol in the treatment of patients with chronic obstructive pulmonary disease （COPD）. Methods Patients with COPD were enrolled from 2014 to 2016 in our hospital. According to whether using metoprolol or not, they were divided into the treatment group and the control group. Their clinical parameters and survival data were recorded. Results There was no significant difference in heart rate, LVEDD and LVEF and other clinical parameters between the two groups. In the control group, LVEDD decreased significantly after treatment （ P 〈 0. 05 ） , while heart rate had decreased trend and LVEF had increased trend without significant difference （ all P 〉 0. 05 ）. Heart rate and LVEDD decreased with significant difference in the treatment group （ all P 〈 0. 05 ） , while LVEF showed a rising trend with marked difference （ P 〈 0. 05 ）. Before the treatment, there was no statistical difference in 6 min walking distance between the two groups, and it became obviously farther 3 months after the treatment （ P 〈 0. 05 ）, which was more pronounced in the treatment group than in the control group 6 months after the treatment （ P 〈 0.05 ）. The level of blood oxygen saturation increased in the treatment group, but it showed no significant difference （ all P 〉 0. 05 ）. Metoprolol treatment could effectively reduce the systolic pressure and heart rate with significant differences （ both P 〉 0. 05 ） and improve life quality. Conclusion Metoprolol can significantly improve heart function and life quality of patients with COPD, and it should be regarded as a clinical drug which can be applied to the treatment in chronic heart failure patients complicated with COPD.