摘要
目的:采用6分钟步行试验,评估酒石酸美托洛尔(倍他乐克)对充血性心力衰竭患者运动耐量的改善。方法:入组110例患者,6分钟步行距离150～425m。均行祛除诱因及5～7天的常规治疗(地高辛、血管紧张素转换酶抑制剂、利尿剂),病情平稳后按入院先后随机分为酒石酸美托洛尔组55例和对照组55例,酒石酸美托洛尔组开始加用酒石酸美托洛尔,起始剂量为6.25mg,2次/日;此后每周剂量增加1倍,直到心率控制在60～65次/分或患者不能耐受或达到100mg/日的目标剂量,不再加量。病情稳定后可带药出院继续治疗。治疗时间为3个月,治疗前后分别行6分钟步行试验及对临床症状的改善进行对照。结果:与对照组相比,酒石酸美托洛尔组心功能改善(P<0.05),心率、血压降低(P<0.05或P<0.01),6分钟步行距离增加(P<0.01)均更显著。结论:酒石酸美托洛尔能有效地改善心功能,提高运动耐量。
Objective：To evaluate the clinical effect of Metoprolol Tartrate （Betaloc） on patients with congestive heart failure（CHF） by 6 minutes walk test（6MWT）. Methods： All the subjects were patients with 6 - minute walking distance between 150 and 425 meters, who were treated with digoxin, angiolensin- converting enzyme inhibitors and diuretic. They were randomly divided into Betaloc group （ 55 eases, 32 males and 23 females） and control group （ 55 eases, 30 males and 25 females ） after states of illness were stable. The Betaloc group treated with Betaloc at the beginning, the initial dosage was 6.25 mg, Bid; Hereafter, the dosage increased every week until heart rate was controlled in 60 -65 per minute, or the patients couldn＇t endure, or achieved 40mg/d desired dosage （only restricted in hospital ）. After the conditions were stable, they could be home to take medicine . The 6 MWT was done in pretreatment and post treatment respectively and compared it with dinical symptom. Results ： Betaloc could remarkably improve heart function （P 〈 0. 05 ）, the heart rate , blood pressure decreased （ P 〈 0.05 or P 〈0.01 ） ,6 - minute walking distance improved（ P 〈 0.01 ）, compared with control group. Conclusion： Betaloc may effectively improve the heart function and exercise tolerance than normal medicine.
