摘要
目的 观察美托洛尔对扩张型心肌病的临床疗效及对远期预后的影响。方法 10 0例扩张型心肌病均经超声心动图及X线心脏三位片确诊 ,按就诊顺序随机分为A、B两组 ,A组 5 0例给美托洛尔 2 5~ 10 0mg/d ,B组 5 0例服同等剂量安慰剂 ,两组基础治疗类同。定期来门诊随访 ,长期坚持服药 1~ 4年 ,平均服药时间为 494天 ,随访满 1年后均复查超声心动图 ,判定疗效的终点事件为病死率及临床心功能状况。结果 美托洛尔使扩张型心肌病患者的心率减慢 ,心功能改善 ,超声心动图复查显示左室舒张末期内径及左房内径缩小 ,左室射血分数增高。 1年随访病死率较对照组无减少 ,但心功能恶化者明显少于对照组。远期随访存活率较对照组明显提高。结论 在扩张型心肌病患者长期坚持使用美托洛尔可使心功能改善 ,生活质量提高 。
Objective To evaluate the clinical therapeutic efficacy and safety of metoprolol for treatment of dilated cardiomyopathy. Methods One hundred patients with idiopathic dilated cardiomyopathy were randomized to take small dose of metoprolol (25-100 mg per day, n = 50) and to placebo ( n = 50) on the basis of conventional treatment. An initial metoprolol dosage of 6 25 mg twice daily was given and increased in 6 25 mg every other day to 25-100 mg daily. The mean of follow up periods was 494 days. The efficacy of metoprolol was assessed by means of echocardiography and clinical symptoms. Primary endpoint was mortality rate during treatment. Results After one year treatment, there were 5 deaths in metoprolol group and 4 in placebo group. 2 patients deteriorated in metoprolol, 9 in placebo group. After metoprolol adimistration for one year, there were more significant improvement in NYHA functional class in metoprolol group than in placebo group. Metoprolol was associated with greater overall reduction of left ventricular end diastolic diameter, from 57 4±6 5 to 54 7± 6 6 ( P< 0 05) and an overall increase in the LVEF% from 31 5±4 0 to 36 7±3 1( P< 0 05) during the first year of therapy. In the metoprolol group, the 2- and 3-year survival rates were 65% and 52% respectively, which were significantly higher than those (46% and 24%) in the control group ( P< 0 05). Conclusion Long term addition of metoprolol to standard therapy may profoundly improve cardiac function and prognosis and prevent clinical deterioration in patients with idiopathic dilated cardiomyopathy when compared with patients without metoprolol treatment.
出处
《中华心血管病杂志》
CAS
CSCD
北大核心
2000年第3期200-202,共3页
Chinese Journal of Cardiology
基金
山西省攻关基金资助项目