酒石酸美托洛尔治疗心脏瓣膜病并心力衰竭的临床疗效

Clinical efficacy of metoprolol tartrate in the treatment of valvular heart disease with heart failure

目的 观察酒石酸美托洛尔治疗心脏瓣膜病并心力衰竭的临床疗效。方法 回顾性选取2017年1月-2020年8月湘西土家族苗族自治州人民医院收治的心脏瓣膜病并心力衰竭患者52例,按照治疗方法不同分为对照组与试验组,各26例。对照组予以常规治疗,试验组在对照组基础上予以酒石酸美托洛尔。2组均持续用药1年。比较2组临床疗效,治疗前后心功能指标[左心室收缩末期内径(LVESD)、左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)、左心室质量指数(LVMI)、左心室射血分数(LVEF)]、神经内分泌指标[内皮素(ET)、醛固酮(ALD)、心钠素(ANP)、血浆肾素(PRA)、血管紧张素Ⅱ(AngⅡ)]及不良反应。结果 试验组总有效率为96.15%,高于对照组的69.23%(χ^(2)=4.837,P=0.028)。治疗后,2组LVESD、LVEDV、LVESV小于治疗前,LVMI低于治疗前,LVEF高于治疗前,且试验组LVESD、LVEDV、LVESV小于对照组,LVMI低于对照组,LVEF高于对照组(P<0.05)。治疗后,2组ET、ALD、ANP、PRA、AngⅡ低于治疗前,且试验组低于对照组(P<0.01)。试验组不良反应总发生率为46.15%,与对照组的42.31%比较,差异无统计学意义(χ^(2)=0.078,P=0.780)。结论 酒石酸美托洛尔治疗心脏瓣膜病并心力衰竭的临床疗效确切,可有效调节患者神经内分泌功能,促进心功能恢复,且药物不良反应较少。

Objective To observe the clinical efficacy of metoprolol tartrate in the treatment of valvular heart disease with heart failure.Methods A total of 52 cases of patients with valvular heart disease with heart failure were retrospectively selected from January 2017 to August 2020 in Xiangxi Tujia and Miao Autonomous Prefecture People’s Hospital,which were divided into control group and experimental group according to different treatment methods,with 26 cases in each group.The control group was given routine treatment,and the experimental group was given metoprolol tartrate on the basis of the control group.Both groups continued to take medicine for 1 year.Clinical efficacy,cardiac function indexes[left ventricular end-systolic diameter (LVESD) left ventricular end-diastolic volume (LVEDV),left ventricular end-systolic volume(LVESV),left ventricular mass index(LVMI),left ventricular ejection fraction(LVEF)],neuroendocrine indexes[endothelin(ET),aldosterone(ALD),atrial natriuretic peptide(ANP),plasma renin(PRA),angiotensinⅡ(AngⅡ)]before and after treatment were compared between the two groups,and the incidence of adverse reactions were observed.Results The total effective rate of the experimental group was 96.15%,which was higher than 69.23%of the control group(χ^(2)=4.837,P=0.028).After treatment,the LVESD,LVEDV and LVESV of the two groups were lower than those before treatment,LVMI was lower than that before treatment,LVEF was higher than that before treatment,and the LVESD,LVEDV and LVESV of the experimental group were lower than those of the control group,LVMI was lower than that of the control group,and LVEF was higher than that of the control group(P<0.05).After treatment,ET,ALD,ANP,PRA and AngⅡin the two groups were lower than those before treatment,and the experimental group were lower than those in the control group(P<0.01).The incidence of adverse reactions in the experimental group was 46.15%,compared with 42.31%in the control group,and there was no significant difference(χ^(2)=0.078,P=0.780).Conclusion Metoprolol tartrate have an exactly clinical effect for valvular heart disease with heart failure,which can effectively regulate the neuroendocrine function and promote the recovery of cardiac function of patients,and the adverse drug reaction is mild.