琥珀酸美托洛尔缓释片对慢性心力衰竭患者治疗的临床研究

Metoprolol Succinate Sustained-release Tablets in Treatment of Patients with Chronic Heart Failure

目的研究琥珀酸美托洛尔缓释片治疗慢性心力衰竭患者的疗效、安全性和耐受性。方法 40例慢性心力衰竭患者在常规治疗基础上加用琥珀酸美托洛尔缓释片,从每日11.875 mg开始,每2周递增一次,直至靶剂量或最大耐受剂量。观察加用琥珀酸美托洛尔缓释片治疗前及治疗后6个月、12个月时一般状况(心率、血压)、心功能情况(NYHA分级、超声心动图、BNP)、不良反应(血常规、肝功、肾功、血糖等)。结果加用琥珀酸美托洛尔缓释片治疗6个月、12个月后心力衰竭症状减轻,心功能明显改善,左室射血分数、左室舒张末期内径、B型尿钠肽较治疗前有显著差异(P<0.01);治疗12个月较治疗6个月改善更明显(P<0.05)。对血常规、肝功能、肾功能和血糖均无显著差异(P>0.05),无明显不良反应发生。结论琥珀酸美托洛尔缓释片治疗慢性心力衰竭疗效、安全性及耐受性良好,可改善慢性心力衰竭患者的预后、提高生存率。

Objective To observe the effect,safety,and tolerability of metoprolol succinate sustained-release tablets in treating patients with chronic heart failure. Methods From 11. 875 mg a day,once every 2 weeks,the dose of metoprolol succinate sustained-release tablets was increased to the tartget dose or maximum tolerated dose in 40 patients with chronic heart failure. The general condition（ heart rate and blood pressure）,heart function（ NYHA grade,ultrasonic Beckoning graph,and BNP）,adverse drug reaction（ blood routine,liver function,renal function,and blood glucose） were observed before treatment and after treatment for 6 and 12 months. Results Compared with treatment without metoprolol succinate sustained-release tablets,the clinical symptom,LVEF,LVEDD,and BNP improved significantly in patients with heart failure after treatment for 6 and 12 months with these tablets（ P 〈0. 01）.Moreover,the efficacy of treatment for 12 months was superior to that of treartment for 6 months（ P〉 0. 05）. Conclusion Patients with heart failure treated with metoprolol succinate sustained-release tablets can markedly improve their prognosis,survival rate,safety and tolerability.