美托洛尔治疗老年冠心病慢性心力衰竭52例疗效观察

Effect of metoprolol on 52 elderly patients with chronic heart failure of coronary heart disease

目的评价β-受体阻滞剂治疗老年冠心病慢性心力衰竭的疗效及安全性.方法 105例老年冠心病慢性心力衰竭患者按就诊顺序随机分为两组,美托洛尔组52例在常规抗心力衰竭治疗基础上加用美托洛尔12.5～25 mg,2/d;对照组53例采用常规抗心力衰竭治疗,未用美托洛尔.定期来诊随访,观察临床表现,监测治疗前后心率、血压、心功能参数变化.结果美托洛尔组显效率53.8%,总有效率88.5%;对照组显效率30.2%,总有效率67.9%,两者比较有显著性差异(P<0.05).美托洛尔组患者心率减慢、血压降低较对照组明显,超声心动图复查显示治疗6个月后左室舒张末期内径缩小,左室射血分数增高较对照组显著.结论美托洛尔为老年冠心病慢性心力衰竭提供一种较为安全有效的药物治疗手段.

Objective To evaluate the clinical effect and safety of metoprolol in elderly patients with chronic heart failure of coronary heart disease. Methods 105 elderly patients with chronic heart failure of coronary heart disease were allocated randomly into metoprolol group and control group. 52 patients in metoprolol group were treated with metoprolol（12.5 - 25mg, twice per day）,53 patients in control group without metoprolol and go on the basis of the routine treatment. The changes of heart rate, blood pressure, heart function, and ultracardiography were observed before and after treatment. Results The effective rate and total effective rate in metoprolol group were 53.8% and 88.5%, 30.2% and 67.9% in control group respectively（ P 〈0.05 ）. After treatment of 6 months, heart rate and blood pressure in metoprolol group were lower than that in control group, heart function and indexes of ultracardiography （LVEF, LVDD） were obviously improved. Conclusions Metoprolol can served as a effective and safe treatment in elderly patients with chronic heart failure of coronary heart disease.