卡托普利及美托洛尔治疗慢型克山病疗效观察

目的通过医生指导患者自我管理,观察卡托普利、美托洛尔对慢型克山病患者的治疗效果。方法 2010年在四川省冕宁县选择63例慢型克山病患者,随机分为卡托普利组、美托洛尔组和对照组,3组病例均给予洋地黄类强心剂、利尿剂等药物进行基础治疗,卡托普利组和美托洛尔组分别在此基础上加用卡托普利或美托洛尔。经12个月治疗,观察临床症状、体征变化,心脏功能改变,心脏大小、心电图、心脏原因死亡情况。结果临床症状（心悸、头晕、气促、咳嗽、乏力）体征（心动过速、唇绀、肝大、浮肿）卡托普利组、美托洛尔组较对照组有明显改善,心电图部分指标（ST-T改变、异位心律）有好转,但是X线胸片以及临床检查心脏大小无改变。全程治疗期间,卡托普利组死亡1例,美托洛尔组无死亡,对照组死亡2例。治疗后心脏功能得到改善。结论应用卡托普利、美托洛尔治疗慢型克山病,可改善心脏功能,改善临床症状和体征,安全可靠,适宜病患长期使用。

Efficacy of Metoprolol and Captopril on Chronic Keshan Disease

Objective To evaluate treatment efficacy of Metoprolol and Captopril on chronic Keshan disease by self-management under the guidance of doctor. Methods In 2010,63 chronic Keshan disease patients were recruited from Mianning county of Sichuan province,and were randomly divided into three groups with respect of cardiac function,age and sex. All participants were treated with digitalis and diuretic; moreover,two of the three groups were treated with Metoprolol and Captopril respectively. After 12 months＇ treatment,the changes of clinical symptoms,cardiac function,heart size,electrocardiogram,blood pressure,heart rate,and the causes for death were compared among the three groups. Results Compared to the control group,the clinical symptoms and signs were significantly improved among patients treated with Metoprolol or Captopril,whereas the blood pressure and heart rate changed little. During the treatment course,two patients died in control group,one died in Captopril group and none died in Metoprolol group. Conclusion Drug treatment for chronic Keshan disease by Metoprolol and Captopril can improve the cardiac function and clinical symptoms,thus could be adopted for long-term treatment for Kesan disease.