β受体阻滞剂治疗扩张型心肌病心力衰竭疗效观察

EFFECTS OF METOPROLOL ON HEART FAILURE IN THE PATIENTS WITH DILATED CARDIOMYOPATHY

目的 :观察β受体阻滞剂倍他洛克对扩张型心肌病 (DCM )心衰的疗效。 方法 :2 8例DCM患者根据用药随机分为治疗组 (倍他洛克 )和对照组 ,采用自身对照和对比法 ,比较治疗后近期和远期的左室功能改变 ,指标包括 :NYHA分级和评分、左室舒张末期直径 (LVIDd)和容量 (LVEDV)、左室收缩末期直径 (LVIDs)和容量 (LVESV)、左室射血分数 (EF)、短轴缩短率(FS)、心搏量 (SV)。结果 :与治疗前相比 ,治疗组在用药 1个月后即出现左室功能指标的改善 ,差异显著 ,随时间延长 ,疗效更显著 ;对照组观察 6个月 ,心功能较前恶化 ,表现为LVESV、LA的增加 ;与对照组相比 ,治疗组患者EF、FS、SV增加 ,LVEDV、LVESV下降 ,NYHA、LA进一步减少 ,差异显著。结论 :长期适当使用 β受体阻滞剂治疗能改善DCM患者心功能、逆转心室重构。

Objectives:To analyze whether the treatment with the selective beta-adrenergic blocking agent metoprolol may have benefical effects in patients with dilated cardiomyopathy(DCM).Methods:28 patients of DCM were divided into 2 groups:treatment group(with metoprolol) and control group.Evolution of left ventricular(LV) function,including NYHA functional classification, LV end-diastolic diameter(LVIDd) and volume(LVEDV),LV end-systolic diameter(LVIDs) and volume(LVESV),LV ejection fraction(EF),fraction shortening(FS),and stroke volume(SV), were compared between two groups and the data before and after drug taken.Results:①In control group,there was significant increase in LVESV and LA after 6 months.②In treatment group,LV function had been remarkably improved one month after treatment with metoprolol and effects were correlated with the time of therapy.③Compared with control group,there were significant differences in EF,FS,NYHA,LVEDV,LVESV,LA,and SV.Conclusions:Long-term treatment of beta-blocker can improve LV function and reverse LV remodeling.