长期口服美托洛尔对心力衰竭合并心房颤动患者预后的影响

Effect of long term oral metoprolol on prognosis of patients with heart failure complicated with atrial fibrillation

目的探讨长期口服美托洛尔对射血分数降低性心力衰竭(HFREF)合并持续性心房颤动(AF)患者预后的影响。方法选择2015年2月至2016年3月在该院就诊的71例HFREF合并AF患者为研究对象,所有患者在常规性治疗基础上长期口服美托洛尔,分析治疗前和治疗6、12个月后疗效及预后情况。结果与治疗前相比,患者治疗6、12个月后左心室射血分数、左心室收缩末期内径、左心室舒张末期内径水平有明显改善,差异均有统计学意义(P<0.05);治疗6、12个月后,心功能Ⅰ、Ⅱ级患者所占比例分别为61.97%、80.28%,均明显高于治疗前的40.85%,差异均有统计学意义(P<0.05);治疗6、12个月后,患者6 min步行距离分别为(328.09±48.15)、(384.67±52.53)m,均明显多于治疗前[(290.38±35.67)m],差异有统计学意义(P<0.05);治疗期间,患者心脑血管事件发生率为16.13%,全因病死率为2.94%,均未出现严重的药物不良反应。结论长期口服美托洛尔治疗HFREF合并AF具有一定的有效性和安全性,能够显著提高患者心脏功能,并降低心脑血管事件发生率及全因病死率,对改善患者预后具有积极的促进作用。

Objective To investigate the effect of long-term oral metoprolol on the prognosis of patients with heart fail-ure with reduced ejection fraction（HFREF）and persistent atrial fibrillation（AF）.Methods From February 2015 to March2016,71 cases patients with HFREF combined with AF were selected as the subjects.All patients were given oral metoprolol on the basis of regular treatment.The curative effect and prognosis before treatment and after 6 and 12 months of treatment were ana-lyzed.Results Compared with before treatment,the level of left-ventricular ejection fraction,left ventricular end systolic diam-eter and left ventricular end diastolic diameter were significantly improved after 6 and 12 months of treatment,and the differ-ence was statistically significant（P〈0.05）.After 6 and 12 months of treatment,the proportion of patients with cardiac function atgrade Ⅰ and Ⅱ was 61.97% and 80.28% respectively,which were significantly higher than those of 40.85% before treatment,and the difference was statistically significant（P〈0.05）.After 6 and 12 months of treatment,the 6 min walking distance of the patients was（328.09±48.15）and（384.67±52.53）m respectively,which were significantly more than before the treatment（[ 290.38±35.67）m],the difference was statistically significant（P〈0.05）.During the treatment period,the incidence of cardio-vascular and cerebrovascular events was 16.13%,and the all-cause mortality rate was 2.94%.There was no serious adverse drugreaction.Conclusion Long-term oral metoprolol is effective and safe in the treatment of HFREF combined with AF.It can signif-icantly improve the cardiac function of the patients,reduce the incidence of cardiovascular events and the all-cause mortalityrate,and has a positive effect on improving the prognosis of the patients.