美托洛尔治疗小儿心肌病的临床观察

Effect of Metoprolol on Children with Cardiomyopathy

目的:观察美托洛尔对心肌病患儿心功能及心室重塑的影响以及药物的安全性。方法:美托洛尔治疗心内膜弹力纤维增生症(EFE)患儿15例,扩张型心肌病(DCM)患儿10例。观察治疗后心功能改善、不良反应情况;比较EFE患儿与DCM患儿的疗效及其预后。结果:美托洛尔治疗后临床心功能明显改善;患儿左室射血分数(LVEF)、左室短轴缩短率(LVFS)、左室舒张末期容积(LVEDV)、左室收缩末期容积(LVESV)、左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)、左室质量(LVm ass)均改善,与治疗前比较,LVEF、LVFS、LVEDV、LVESV、LVESD差异有统计学意义(P<0.05)。结论:美托洛尔能改善心肌病患儿心功能,抑制心室重塑,长期治疗具有良好耐受性;早期诊断和正规治疗小儿心肌病能降低病死率,提高治愈率。

Objective：To observe the effect of metoprolol on cardiac function and ventricular remodeling in children with cardiomyopathy,and to explore the security of metoprolol.Methods： Fifteen children with endocardial fibroelastosis（EFE） and 10 children with dilated cardiomyopathy（DCM） received metoprolol.The improvement of cardiac function and side effect after treatment with metoprolol were observed.The therapeutic effect and prognosis in both groups were compared.Results：The cardiac function was obviously improved;left ventricular ejection fraction（LVEF）,left ventricular fractional shortening（LVFS）,left ventricular end-diastolic volume（LVEDV）,left ventricular end-systolic volume（LVESV）,left ventricular end-diastolic diameter（LVEDD）,left ventricular end-systolic diameter（LVESD） and left ventricular mass（LVmass） were all improved after the treatment with metoprolol.LVEF,LVFS,LVEDV,LVESV,LVESD were significantly different before and after the treatment（P0.05）.Conclusions：Metoprolol can improve cardiac function and inhibit ventricular remodeling in children with cardiomyopathy.Long-term treatment with metoprolol is well-tolerated.Regular treatment and early diagnosis of cardiomyopathy can reduce the mortality and improve the cure rate.