美托洛尔对难治性心力衰竭的临床观察

目的 :观察美托洛尔对难治性心力衰竭的临床疗效。方法 :10 6例难治性心衰患者 ,以接受治疗先后随机分成试验组和对照组 ,分别接受美托洛尔和安慰剂。在常规强心、利尿、扩血管治疗基础上加用美托洛尔 ,从小剂量开始 ,在耐受情况下逐渐加大剂量 ,坚持服药 3～ 6个月 ,每 3个月复查超声心动图。结果 :试验组中 8例患者由于不能耐受美托洛尔 ,表现为心输出量进一步减少 ,为防止发生心源性休克而终止用药。 45例耐受良好 ,7～ 12周在心率减慢的基础上出现心功能改善。 3～ 6个月后超声心动图提示左室射血分数、心脏指数提高。结论 :长期服用 β1 受体阻滞剂美托洛尔可显著改善难治性心力衰竭患者症状、NYHA分级、生活质量和提高左室射血分数及心脏指数。

Clinical observation on Metoprolol in the treatment of refractory heart failure

Objective To evaluate the clinical therapeutic effect of Metoprolol for refractory heart failure.Methods 106 patients with refractory heart failure were randomly divided into experimental group and control group taking Metoprolol and placebo respectively on the basic treatment.An initial Metoprolol dosage was 6.25 mg and to increase dosage gradually if patients could endure.The effect was assessed by means of echocardiography.Results There was more significant improvement in NYHA functional class,left ventricular ejection fraction(LVEF)and cardiac index(CI)in experimental group than in control group.But 8 patients had to give up to avoid cardiogenic shock for decreasing cardiac output in experimental group.Conclusions Long term addition of beta blocker Metoprolol to standard therapy may profoundly improve cardiac function,clinical symptoms,LVEF and CI in patients with refractory heart failure when compared with patients without Metoprolol treatment.