美托洛尔治疗扩张型心肌病的疗效观察

Clinical Effect Observation of Metoprolol in the Treatment of Patients with Dilated Cardiomyopathy

目的观察β-受体阻滞剂美托洛尔治疗扩张型心肌病的疗效。方法 48例确诊为扩张型心肌病的患者随机分为两组,对照组20例给予常规治疗;试验组28例在常规治疗的基础上加用β-受体阻滞剂美托洛尔(6.25～50.00mg,2次/d),3个月、6个月、1年后复查长程心电图(Holter)、彩色多普勒心脏超声,并比较两组患者的疗效、心律失常发生率、左室舒张末期内径(LVEDD)、左室射血分数(LVEF)和病死率。结果试验组3个月时心律失常发生率明显低于对照组,差异有统计学意义(P<0.05);6个月时试验组疗效明显优于对照组,LVEF明显高于对照组,心律失常发生率明显低于对照组,差异有统计学意义(P<0.05);1年时,试验组心律失常发生率低于对照组,差异有统计学意义(P<0.05)。结论在常规治疗基础上加用美托洛尔能改善患者的心功能,降低心率失常发生率。

Objective To observe the clinical therapeutic efficacy of metoprolol in treatment of dilated cardiomyopathy. Methods 48 patients with idiopathic dilated cardiomyopathy were randomly divided into control group （n =20） and experimental group （ n = 28）. Control group accepted conventional treatment; experimental group took small dose of metoprolol （6. 25 ~ 50. 00mg, per day）. Echocardiography and Holter were taken after three months, six months and one year. Compared the efficacy, rate of cardiac arrhythmia, left ventricular end - diastolic diameter （LVEDD）, left ventricular ejection fraction （LVEF） and fatality rate in two groups. Results The arrhythmia rate in experimental group was significantly lower than that of control group at 3 months, the difference was statistically significant （ P 〈 0. 05 ） ; in experimental group, efficacy was better than control group, LVEF was significantly higher than that of the control group, the incidence of arrhythmia was significantly lower than that of the control group at 6 months, the difference was statistically significant （ P 〈 0. 05 ） ; The arrhythmia rate in experimental group was significantly lower than that of control group at 1 year, the difference was statistically significant （P 〈 0.05 ）. Conclusion Long term addition of metoprolol to standard therapy may profoundly improve cardiac function and decrease the rate of cardiac arrhythmia in patients with idiopathic dilated cardiomyopathy when compared with patients without metoprolol treatment.