培哚普利联合美托洛尔治疗老年人慢性心力衰竭

目的 观察培哚普利联合美托洛尔治疗老年人慢性心力衰竭的疗效.方法 136例60岁以上慢性心力衰竭患者随机分为两组,对照组(68例)采用洋地黄、利尿剂和硝酸酯类药物等治疗,治疗组(68例)在对照组治疗基础上加服培哚普利和美托洛尔.4～8周为1个疗程.观察两组治疗前后心功能、左室射血分数、六分钟步行试验和血浆脑利钠肽(BNP)改变等.结果 治疗后,治疗组总有效率94.1％,明显高于对照组的70.6％(x2=5.96,P＜0.05);两组治疗后慢性心力衰竭评价指标均较治疗前明显改善(t=2.56、3.23、2.48、2.53、2.79、3.31,均P＜0.05),治疗组较对照组改善更明显(t=2.87、3.12、2.59,均P＜0.05),两组治疗过程中均未发生严重不良反应.结论 培哚普利联合美托洛尔治疗慢性心力衰竭可改善心室重构,提高治疗效果.

The effect of perindopril and metoprolol in the treatment of geriatric chronic heart failure

Objective To evaluate the clinical therapeutic efficacy of perindopril and metoprolol in the treat- ment of chronic heart failure in old patients（ ≥60 years old）. Methods 136 old patients（ ≥60 years old） with chro- nic heart failure were randomly divided into the treatment group（ n = 68 ） and the control group（ n = 68 ）. The control group received the routine treatment with digitalis, diuretics and nitroglycerin. The treatment group was given perindopril and metoprolol orally besides the routine treatment. The perindopril was taken orally 2mg per time, and once a day, and gradually raised to maximum does 8mg per time, once a day. The metoprolol was taken orally 25mg per time, twice a day, also gradually raised to maximum dose 25mg per time, twice a day. 4-8 weeks were a treatment cycle. The cardiac function, left ventricular ejection fraction （ LVEF ） , the 6-minute walk and plasma brain natriuretic pep-tide （BNP） were observed before the beginning of the therapy and after, respectively. Results All patients improved their cardiac function,LVEF, plasma BNP and the 6-minute walk significantly after the therapy （ t = 2. 56,3.23,2.48, 2.53,2.79,3.31, all P 〈 0.05 ）. The improvement of the treatment group was more significantly than that of the con- trol group （t = 2.87,3.12,2.59, all P 〈 0. 05 ）. The total effective rate of treatment group was 94.1% , significantly higher thar 70.6% of control group （ X2 = 5.96,P 〈 0.05 ）. Conclusion The therapy of perindopril and metoprolol in old patients with chronic heart failure could improve ventvicular remodeling and the effect.