卡维地洛与美托洛尔预防冠脉搭桥术后房颤的疗效比较

Efficacy comparison of carvedilol and metoprolol on preventing atrial fibrillation after coronary artery bypass grafting

目的观察卡维地洛与美托洛尔在冠脉搭桥术后预防房颤的疗效。方法接受冠脉搭桥术的患者共200例,随机分成2组,每组100例,分别给予卡维地洛和美托洛尔治疗。所有患者于术前3 d开始接受药物。美托洛尔组起始剂量50 mg,每日2次;卡维地洛组起始剂量12.5 mg,每日2次。药物的剂量依患者的血流动力学反应进行调整,一直监测到术后第3天。结果美托洛尔组43例(43%)发生房颤,卡维地洛组20例(20%)发生房颤,两组比较,差异有统计学意义(P=0.001)。结论卡维地洛预防冠脉搭桥术后早期房颤的效果优于美托洛尔。

Objective To investigate the efficacy of carvedilol compared with metoprolol succinate in preventing postoperative AF.Methods 200 patients who had undergone CABG were randomized to receive either metoprolol or carvedilol（100 cases in each group）,and all patients received the drugs 3 d prior to surgery.Metoprolol was started at 50 mg twice daily and carvedilol was started at 12.5 mg twice daily.The doses were titrated according to the patients′ hemodynamic responses.All patients were monitored for 3 d after the surgery.Results 43 patients（43%）in metoprolol group and 20 patients（20%）in carvedilol group developed AF（P=0.001）.Conclusion Carvedilol is superior to metoprolol in decreasing development of early postoperative AF.