不同剂型美托洛尔对慢性收缩性心力衰竭心率变异性的影响

Effects of metoprolol of different drug forms on heart rate variability in patients with chronic congestive heart failure

目的探讨不同剂型美托洛尔对慢性收缩性心力衰竭(CHF)心率变异性(HRV)的影响。方法 60例CHF患者被随机分为平片组及缓释片组,在常规抗心衰治疗基础上,分别服用美托洛尔平片和缓释片;从小剂量开始,逐步增加剂量,连续6个月。观察治疗前后HRV、左室射血分数(LVEF)、病死率及因心衰加重住院情况。结果治疗后LVEF两组均略增加。观察期间在病死率、再住院率方面两组间差异均无统计学意义(P>0.05);但在缓释片组因心衰加重再住院有减少趋势。两组治疗后HRV指标均明显改善,缓释片组优于平片组(P<0.05)。结论美托洛尔缓释片较平片明显改善CHF患者HRV。

Objective To compare the therapeutic efficacy of two drug forms of metoprolol on heart rate variability（HRV）in patients with chronic congestive heart failure（CHF）.Methods Sixty patients with CHF were randomly divided into two groups with 30 cases each.The patients took the immediate-release metoprolol（group IRM）or sustainded-release metoprolol（group SRM）,which started with the low dosage and then increased gradually for continuous 6 months.The changes of HRV were observed by ambulatory electrocardiogram（ECG）before and 6 mouths after treatment.Left ventricular ejection fraction（LVEF）,mortality and readmission rate secondary to heart failure were observed.Results After treatment,LVEF was increased slightly in both groups.There were no significant differences in the mortality and readmission rates in both groups（P0.05）.But there was a tendency of decreased readmission rate secondary to heart failure in group SRM.The improvements of HRV parameters were better in group SRM than those in group IRM（P0.05）.ConclusionSustainded-release metoprolol is better than immediate-release metoprolol in improving HRV in patients with CHF.