美托洛尔与卡托普利联合治疗慢性心力衰竭

Metoprolol Combined with Captopril Treating Chronic Heart Failure

目的了解或评价美托洛尔与卡托普利联合治疗慢性充血性心力衰竭的疗效和安全性。方法以90例心脏病伴轻中度心力衰竭的患者为研究对象。按随机化原则分为3组:美托洛尔联合卡托普利组、美托洛尔组、卡托普利组,在心力衰竭标准用药基础上,美托洛尔、卡托普利均从小剂量开始,逐渐递增至目标剂量,在8个月内检查超声心动图3次,以评价左室舒张末期容积。结果治疗后3组的左室射血分数(LVEF)均有增加,左室收缩末期容积(LVESV)和左室舒张末期容积(LVEDV)均有减少,但美托洛尔联合卡托普利组与美托洛尔组、卡托普利组比较,差异有显著性(P<0.05)。美托洛尔联合卡托普利组有24例(80%)耐受目标剂量,其多见的不良反应为头晕,但不良反应发生率与单独美托洛尔组、单独卡托普利组比较,差异无显著性。3组均未发现肝、肾功能损害或血象、电解质和糖代谢变化。结论美托洛尔与卡托普利用在心衰标准用药基础上治疗轻、中度CHF患者安全有效,可显著改善左室重塑。

Objective To study or evaluate the therapeutic effect and security of captopril combined with metoprolol treating chronic heart failure.MethodA total of 90 patients with coronary atherosclerotic heart disease accompanied with mild/midrange heart failure were chosen and divided into 3 groups randomly,including patients treated with metoprolol combinated with captopril（30 cases）,patients treated with metoprolol only（30 cases）,patients treated with captopril only（30 cases）.Basing on the standard amount of drug consumption,the administration of metoprolol and captopril was begined with small dose and then increased to target dose.UCG was examined for 3 times within 8 months to evaluate left ventricular end diastolic volume.ResultsAfter the treatment,LVEF increased,LVESV and LVEDV decreased in three groups.Comparing with the group treated with metoprolol only and the group treated with captopril only,there were significant differences in the group treated with metoprolol combined with captopril（P〈0.05）.24 case（80%） in the group treated with metoprolol combined with captopril reached tolerant target dose and its common side effect was dizziness.Comparing with other two groups,there were no obvious differences.No damage of livers and kidneys and no changes of hemogram,electrolyte or glycometabolism were found.ConclusionsBased on the standard amount of drug consumption,metoprolol combined with captopril is safe and effective to mild or midrange CHF and can improve the reshaping of left ventricle.