目标剂量美托洛尔缓释片对慢性心力衰竭患者的影响

Effects of target dose of metoprolol sustained-release tablets on patients with chronic heart failure

目的探讨目标剂量美托洛尔缓释片对慢性心力衰竭(CHF)患者的影响。方法将210例CHF患者随机分为观察组和对照组,每组105例。在常规心衰治疗基础上,观察组服用目标剂量美托洛尔缓释片,对照组服用固定小剂量美托洛尔缓释片。10个月后,比较2组患者总有效率、左室射血分数(LVEF)、左室收缩末期容积(LVESV)、左室舒张末期容积(LVEDV)、再次住院率及不良事件发生情况,以及治疗前后的静息心率(RHR)、N末端B型脑钠肽(NT-proBNP)、6 min步行距离(6 MWT)的变化。结果观察组患者总有效率显著高于对照组,而再次住院率显著低于对照组,差异均有统计学意义;观察组患者LVEF显著高于对照组,而LVESV及LVEDV显著低于对照组;观察组RHR及NT-proBNP显著低于对照组,而6MWT显著高于对照组。结论目标剂量美托洛尔缓释片能有效提高CHF患者的临床疗效,改善运动耐量,降低再次住院率,改善患者生活质量,其疗效优于固定小剂量。

Objective To tablets on the patients with chronic explore effects of target dose heart failure （CHF）. Methods of metoprolol sustained-release Two hundred and ten patients with CHF were randomly divided into observation group and control group, 105 cases in each group. Based on the conventional treatment of heart failure, the observation group was given target dose of metoprolol sustained-release tablets, while the control group given the fixed small dose. Ten months later, the total efficacy rate, left ventricular ejection fraction （LVEF）, left ventricular end systolic volume （LVESV）, left ventricular end diastolic volume （LVEDV）, a second hospitalization rate and adverse reactions as well as the changes of rest heart rate （RHR）, N-terminal B-type natriuretic peptide （NT-proBNP） and 6 min walking test （6 MWT） before and after treatment were compared in the two groups. Results The total efficacy rate of the observation group was markedly higher than that of the control group, while the second hospitalization rate obviously lower, the difference having statistical significance. LVEF and 6 MWT of the observation group were evidently higher than that of the control group, while LVESV, LVEDV, RHR and NT-proBNP conspicuously lower. Conclusion The target dose of metoprolol sustained-release tablets can effectively improve the clinical effect of patients with CHF, ameliorate exercise tolerance, decrease a second hos- pitalization rate, enhance the quality of life, and its therapeutic effect is superior to the fixed small dose.