β受体阻滞剂对心衰患者脑钠肽及运动耐量的影响

The Effects of Carvedilol and Metoprolol on Natriuretic Peptide and Exercise Tolerance in Patients with Chronic Heart Failure

目的比较卡维地洛与美托洛尔治疗对慢性充血性心力衰竭(CHF)患者血浆脑钠肽(BNP)及运动耐量的影响。方法将CHF患者68例随机分为两组:卡维地洛组35例,美托洛尔组33例,治疗观察时间均为24周,检测治疗前后两组患者的血压、血浆BNP水平、超声心动图及6分钟步行试验距离等。结果治疗24周后,两组患者血浆BNP水平、超声心动图及6分钟步行试验距离与治疗前比较差异有统计学意义(P<0.05)。治疗后两组间血浆BNP水平、6分钟步行试验(6MWT)距离比较差异有统计学意义(P<0.01)。结论卡维地洛与美托洛尔均能降低血浆BNP水平、改善患者运动耐量,卡维地洛治疗改善患者运动耐量更显著。

Objective To evaluate weather or not carvedilol and metoprolol can improve brain natriuretic peptide（BNP） and exercise tolerance of patients with chronic heart failure（CHF）. Methods All 68 patients were randomly divided into tow groups ： thirty-five patients in Carvedilol group, thirty-three patients in metoprolol group, treatment duration for 24 weeks. Blood pressure, plasma BNP levels, echocardiography, and 6-minute walk test distance in the two groups were tested before and after treatment. Results 24 weeks after the treatment,there were statistically differences in plasma BNP levels, echocardiography, and 6-minute walk test distance compared with those before treatment（ P 〈 0.05）. There were statistically differences in plasma BNP levels and 6-minute walk test distance after treatment （P 〈 0.01 ）. Conclusion Carvedilol and metoprolol were able to reduce plasma BNP levels, improve exercise tolerance, and carvedilol was more effective than metoprolol in improve exercise tolerance in patients with CHF.