美托洛尔对陈旧性心肌梗死患者左室重构及心功能的影响

THE EFFECTS OF METOPROLOL ON REMODELING OF LEFT VENTRICLE AND HEART FUNCTION OF THE PATIENTS WITH REMOTE MYICARDIAL INFARCTION

目的:探讨美托洛尔对陈旧性心肌梗死(简称心梗)患者心室重构及心功能的影响。方法:陈旧性心梗患者48例,心功能(NYHA)Ⅱ～Ⅲ级,常规治疗基础上随机分为治疗组和对照组,治疗6个月,观察美托洛尔对心室重构、心功能的影响,采用超声心动图进行对比观察。结果:美托洛尔平均用量(39.8±13.8)mg/d,治疗6个月,反映左室重构的可靠指标(LVID、LVMW)、左室收缩功能的可靠指标(LVEDV、LVESV、EF)及反映左室舒张功能的指标(E、A、E/A比值)均有明显改善(P均<0.01)。上述指标对照组改善不明显。临床疗效判断:治疗组显效71.4%,有效21.4%,总有效率为92.8%;对照组显效10%,有效50%,总有效率为60%;治疗组1例死亡(死亡率3.5%),而对照组死亡4例(死亡率20%)。结论:美托洛尔在强心、利尿、血管紧张素转换酶抑制剂基础上,应用美托洛尔能显著改善陈旧性心梗患者的心功能、心室重构,同时可降低死亡率。

Objective:To study the effects of metoprolol on left ventricular remodeling and the function of hearts of the patients suffering remote myocardial infarction.Methods :48cases of the patients suffering remote myocardial infarction,the function of hearts(NYHA)from gradeⅡtoⅢ,were randomly divided into treating and control groups.Metoprolol(39.8±13.8)mg /d plus routine treatment and only routine treatment were used in the treating and control groups respectively for six months to observe the effects of metoprolol on left ventricular remodeling and the function of heart by echocardiogram.Results:The all reliable indices of the left ventricular remodeling(LVID,LVMW),the contraction function of the left ventricular(LVEDV?LVESV?EF)and the left ventricular diastolic function(E?A?E/A ratio)showed distinctly improve(P<0.01),but did not show distinctly improve in the control group.The clinical rates of remarkable effect were71.4%and10.0%;effective rates21.4%and50.0%;total effective rates92.8%and60.0%;the dead rates were3.5%(1case)and20.0%(4cases)respectively in the treating group and control group.Conclusion:On the basis of cardiotonic,diuretic and AECI ,metoprolol can distinctly improve left ventricular remodeling and the function of hearts of the patients suffering remote myocardial infarction and reduce dead rate in the meantime .