美托洛尔对慢性充血性心力衰竭患者左室扭转异常的治疗效果观察

Treatment effectiveness observation of Metoprolol in treatment of left ventricular torsion abnormality in patients with chronic heart failure

目的探讨美托洛尔治疗慢性充血性心力衰竭左心室扭转异常患者的临床疗效及应用价值。方法选择北京市昌平区医院治疗的慢性充血性心力衰竭左心室扭转异常患者84例,采取随机数字表法分为观察组和对照组,每组各42例。对照组给予常规治疗,观察组在对照组基础上联合美托洛尔治疗,记录两组临床疗效。记录两组患者治疗前后左心室射血分数和左心室舒张末期内径变化。计算心底位旋转角度峰值、心尖位旋转角度峰值、扭转角度峰值变化情况。结果观察组治疗显效22例,有效17例,无效3例;对照组治疗显效10例,有效21例,无效11例,组间对比差异有统计学意义(P<0.05)。观察组治疗后左心室射血分数为(49.38±5.97)%,左心室舒张末期内径为(52.38±4.01)mm;对照组治疗后左心室射血分数为(44.78±4.46)%,左心室舒张末期内径为(58.23±5.32)mm,组间对比差异有统计学意义(P<0.05)。观察组治疗后心尖位旋转峰值(5.81±2.86)°,心底位旋转峰值(-3.79±2.75)°,左心室扭转峰值(9.24±3.86)°;对照组治疗后心尖位旋转峰值(3.65±1.34)°,心底位旋转峰值(-2.82±1.50)°,左心室扭转峰值(5.62±1.68)°,组间对比差异有统计学意义(P<0.05)。结论采用美托洛尔治疗慢性充血性心力衰竭左心室扭转异常疗效可靠,能够提高患者心脏功能,同时可以改善左心室重构增强左心室扭转,改善患者预后,值得在临床上大力推广使用。

Objective To study the clinical efficacy and application value of metoprolol in the treatment of left ventricular torsion abnormality(LVTA) in patients with chronic heart failure(CHF). Methods The LVTA patients with CHF(84 cases) in Changping Hospital were randomly divided into observation group and control group, the patients in control group were given conventional treatment, and the patients in observation group were given metoprolol treatment based on control group. The clinical curative effects of two groups were recorded. Results The observation group had 22 cases treatment markedly, 17 cases effective, and 3 cases invalid; In the control group there were 10 cases of treatment, 21 cases effective, and 11 cases invalid, the difference was statistically significant between the groups(P < 0.05). In the observation group, after treatment, left ventricular ejection fraction was(49.38 + 5.97)%, left ventricular end diastolic diameter was(52.38 + 4.01) mm. In the control group, left ventricular ejection fraction after treatment was(44.78 + 4.46)%, left ventricular end diastolic diameter was(58.23 + 5.32) mm, and the difference was statistically significant between the groups(P < 0.05). In the observation group after treatment, apical rotation peak was(5.81 + 2.86) °, the bottom of my heart bit rotation peak was(-3.79 + 2.75) °, left ventricular torsion peak was(9.24 + 3.86) °. In the control group, apical rotation peak group therapy was(3.65 + 1.34) °, the bottom of my heart bit rotation peak was(-2.82 + 1.50) °, left ventricular torsion peak was(5.62 + 1.68) °, and the difference was statistically significant between the groups(P < 0.05). Conclusion The curative effect of metoprolol in treatment of LVTA in patients with CHF was reliable, metoprolol could improve heart function of patients, improve left ventricular remodeling, enhance left ventricular torsion, and improve the prognosis of patients. which is worth to popularize in clinical use.