美托洛尔联合托拉塞米治疗肥厚型心肌病的临床效果观察

Efficacy of metoprolol combined with torasemide in the treatment of hypertrophic cardiomyopathy

目的观察肥厚型心肌病采用美托洛尔联合托拉塞米治疗的临床疗效。方法94例肥厚型心肌病患者,依据随机抽签法分为对照Z组(红签)及联合用药H组(蓝签),每组47例。对照Z组予以美托洛尔治疗,联合用药H组予以美托洛尔+托拉塞米联合治疗。对比两组患者治疗前后的心功能指标[左心室收缩末期容积(LVESV)、左心室舒张末期容积(LVEDV)、左室射血分数(LVEF)]变化情况及不良反应发生率。结果联合用药H组不良反应发生率为8.51%(4/47),对照Z组不良反应发生率为2.13%(1/47),对比差异无统计学意义(P>0.05)。治疗2个月后,两组患者LVESV、LVEDV小于治疗前,LVEF高于治疗前,且联合用药H组LVESV(49.22±1.03)ml、LVEDV(91.33±2.36)ml小于对照Z组的(52.31±1.42)、(98.54±2.62)ml,LVEF(64.35±2.36)%高于对照Z组的(62.49±1.97)%,差异有统计学意义(P<0.05)。结论对肥厚型心肌病采用美托洛尔联合托拉塞米治疗,可有效改善患者心功能,确保患者安全,值得推广。

Objective To obeserve the clinical efficacy of metoprolol combined with torasemide in the treatment of hypertrophic cardiomyopathy.Methods A total of 94 patients with hypertrophic cardiomyopathy were randomly divided into control group Z(red label)and combined medication group H(blue label),with 47 cases in each group.The control group Z was treated with metoprolol,and the combined medication group H was treated with metoprolol+torasemide.Both groups were compared in terms of cardiac function indexes[left ventricular end-systolic volume(LVESV),left ventricular end-diastolic volume(LVEDV),left ventricular ejection fraction(LVEF)]before and after treatment,and the incidence of adverse reactions.Results The incidence of adverse reactions in the combined medication group H was 8.51%(4/47),and the incidence of adverse reactions in the control group Z was 2.13%(1/47);the difference was not statistically significant between the two groups(P>0.05).After 2 months of treatment,the LVESV and LVEDV in the two groups were lower than those before treatment in this group,and LVEF was higher than that before treatment in this group;the LVESV(49.22±1.03)ml and LVEDV(91.33±2.36)ml of the combined medication group H were less than(52.31±1.42)and(98.54±2.62)ml of the control group Z;the LVEF(64.35±2.36)%of the combined medication group H was higher than(62.49±1.97)%of the control group Z;the differences were all statistically significant(P<0.05).Conclusion In the treatment of hypertrophic cardiomyopathy,metoprolol combined with tolasemide can be used to effectively improve the cardiac function of patients and ensure the safety of patients,which is worthy of promotion.