摘要
目的:观察美托洛尔(Metoprolol)与依那普利(Enalapril)对严重充血性心力衰竭室性心律失常的影响。方法:对42例充血性心力衰竭(NYHAII~IV级)伴有室性心律失常患者,在强心利尿基础上随机给予美托洛尔(12.5~25.0mg/d)或依那普利(5~40mg/d),治疗均为16周。分别于治疗前后进行24小时动态心电图监测与临床心功能评估。结果:治疗前美托洛尔与依那普利组24小时室性心律失常总检出率及各类型(简单型、复杂型及室性心动过速)检出率均无明显差异(P均>0.05),治疗后24小时室性心律失常总检出率美托洛尔组下降48.7%,依那普利组下降19.5%,二者比较差异有显著性(P<0.01);复杂室性心律失常及室性心动过速检出率美托洛尔组分别下降78.6%与100.0%(P均<0.01),依那普利组仅分别下降23.1%与12.5%(P均>0.05)。两组患者心功能均获不同程度的改善。结论:美托洛尔与依那普利均可改善严重充血性心力衰竭患者心脏功能,而美托洛尔还同时具有干预高级别室性心律失常发生的特殊效应。
Objective:To observe the effect of metoprolol and enalapril on ventricular arrhythmia in patients with severe congestive heart failure. Methods:Forty two patients of ventricular arrhythmia(VA) with congestive heart failure (NYHA III IV) under conventional therapy were randomized to metoprolol (12 5 25 0 mg/d) or enalapril (5 40 mg/d) for 16 weeks.Before and after treatment VA was recorded by 24 hour ambulatory electrocardiographic monitoring and cardiac function was estimated by clinical symptoms and signs. Results:Before the treatment the incidences of VA in total and variant types were not significantly different between the two groups,while after the treatment the total incidence of VA in 24 h reduced by 48 7% and 19 5%( p <0 01) in the metoprolol and enalapril groups,respectively.The incidences of complex VA and ventricular tachycardia were reduced by 78 6% and 100%(all p <0 01),respectively in the metoprolol group,and only reduced by 23 1% and 12 5% (all p >0 05),respectively in the enalapril group.The improvment of cardiac function was similiar in both groups. Conclusion:Both metoprolol and enalapril could improve cardiac function,but only metoprolol could reduce the incidence of high class VA in patients with severe congestive heart failure.
出处
《中国循环杂志》
CSCD
1996年第12期723-725,共3页
Chinese Circulation Journal
关键词
充血性
心力衰竭
心律失常
美托洛尔
依那普利
Heart failure
congestive
Ventricular arrhythmia
Metoprolol
Enalapril (Chinese Circulation Journal
1996
11:723.)