美托洛尔和安体舒通对CHF患者QT间期离散度的影响

Effects of Metoprolol and Spironolactone on QT Dispersion in Patients with CHF

目的 :评估美托洛尔和安体舒通对充血性心力衰竭 (CHF)患者 QT间期离散度 (QTd)的影响。方法 :选择6 0例 NHYA分级 级的 CHF患者 ,在接受 3周常规治疗 (卡托普利、利尿剂和地高辛 )后 ,随机分入 3组 ,第 1组维持治疗不变 ,第 2组加用安体舒通 ,第 3组加用美托洛尔。在第 3周和第 12周 ,所有患者评估生化指标、超声心动图指标和测量 QTd。结果 :与第 1组相比 ,在 12周后 ,校正 QTd(ms)在第 2组和第 3组中显著降低 ,P<0 .0 5。结论 :在常规治疗基础上加用美托洛尔或安体舒通 ,可以减小 QTd和校正的 QTd,改善患者的一般状况。安体舒通和美托洛尔对于 QTd和校正的 QTd的效应相似。

Objective:To eval uate the effects of metoprolol and spironolactone added to a conventional treatm ent protocol on QT dispersion in HF patients.Methods:A total of 60 NYHA class III patients were included in this study. The conventional treatment protocol was standardized by giving captopril, furosemide, and digoxin to all patients for 3 weeks at the same doses. At the end of this period, the patients were divided i nto three groups. Conventional treatment was continued in group 1, spironolacton e was added in group 2, and metoprolol was added in group 3. Patients were follo wed up for 12 weeks and clinical and laboratory tests were conducted at 3rd week an d 12th week.Results:No significant change in corrected QTd was observed in gro up1 at the end of 12 weeks. However, corrected QTd was reduced by 33.8% (80 ± 2 ms to 53 ± 1 ms; P<0. 05) in group 2 and by 32.9% (79 ± 2 ms to 53 ± 2 ms;P<0.05) in group 3.Conclusion:The addition of sp ironolactone or metoprolol to a conventional treatment in HF patients resulted i n improved clinical conditions and the significant decrease in corrected QTd. Th e effects of spironolactone and metoprolol on corrected QTd were similar. M