美托洛尔对收缩性心力衰竭心室重塑及心功能的研究

Metoprolol On Ventricular Remodeling And Cardiac Function In Systolic Heart Failure

目的:评估美托洛尔对慢性充血性心力衰竭(CHF)的临床疗效。方法将96例由于不同病因所致的心力衰竭患者随机分成两组,对照组48例,治疗组48例;心功能分级Ⅰ-Ⅳ级(按NYHA分级)。对照组仅给予常规抗心衰药物(如利尿剂、硝酸酯类、洋地黄、ACEI、心酰胺)治疗,治疗组在常规治疗的基础上加用小剂量美托洛尔,并逐步加大剂量治疗6个月,疗程结束后,对两组治疗前后的临床症状及心功能分级改善情况进行对比。结果治疗组临床症状改善情况明显优于对照组,差异有统计学意义(P<0.05);与对照组比较,治疗组心脏指数(CI)、心搏量(CO)、射血分数EF、VVS、LV等均有显著改善(P<0.05);但两组心功能分级改善情况差异不明显(P>0.05)。结论在常规治疗基础上加用美托洛尔对慢性充血性心力衰竭安全有效,不仅能显著抑制心室重塑发展,降低患者死亡率,长期应用还能有效改善患者预后(疗程>半年)。

Objective To evaluate the clinical efficacy of metoprolol on chronic congestive heart failure(CHF).Method 96 patients with heart failure caused by different causes can be divided into two groups:treatment group(48 cases and control group 48 cases;Heart function classⅠ-Ⅳ(according to the NYHA classification)two groups of patients were given routine heart failure treatment,diuretics,ACE),digitalis,amide,nitrate),treatment group with small dose of metoprolol,and gradually increase the dose of treatment for 6 months,after the treatment,compared two groups before and after treatment of clinical symptoms and improve cardiac function classification.Result(1)Clinical symptoms improved in treatment group is better than that of control group,P<0.05).The treatment group cardiac index(CI),stroke volume(CO)、ejection fraction、EF、VVS、LVD were significantly improved(P<0.05)as compared with the control group;but the difference of cardiac function classification is not significantly(P>0.05).Conclusion On the basis of conventional treatment combined with metoprolol on chronic congestive heart failure is safe and effective,effectively inhibit development of ventricular remodeling,significantly reduce the mortality of patients,long-term treatment can obviously improve the prognosis of patients with heart failure(course>half a year).