美托洛尔对慢性心力衰竭伴慢性心房颤动患者的作用

目的:探讨地高辛联用美托洛尔对慢性心力衰竭(CHF)伴慢性心房颤动(AF)患者的疗效。方法:选择CHF伴慢性AF患者106例,随机分为地高辛治疗组(54例)和美托洛尔+地高辛组(52例),观察两组1月疗效并随访1年期间因心脏原因的再住院率、死亡率。结果:治疗1月后,与地高辛组相比,美托洛尔+地高辛组静息心室率[(91.6±8.5)次/min比(72.8±9.7)次/min]和运动前后即刻心室率差值显著降低[(23.1±4.2)次/min比(12.3±4.7)次/min],6min步行距离显著增加[(256.4±90.4)m比(299.8±94.1)m],P均<0.05;随访1年,与地高辛组相比,美托洛尔+地高辛组因心力衰竭再住院率(42.6%比19.2%)、死亡率(20.4%比11.5%)明显降低,NYHA分级明显改善、6min步行距离明显增加,左室舒张末容积、左室收缩末容积明显减小,左室射血分数明显提高,生活质量明显改善,P均<0.05。结论:在常规用药的基础上,地高辛联用美托洛尔的1月疗效与1年后疗效都明显优于单用地高辛的治疗。

Effects of metoprolol in patients with chronic heart failure complicated chronic atrial fibrillation

Objective: To investigate therapeutic effects of metoprolol combined with digoxin in patients with chronic heart failure(CHF) complicated chronic atrial fibrillation(AF).Methods: A total of 106 CHF + chronic AF patients were randomly divided into metoprolol + digoxin group(n=52) and digoxin group(n=54).Short-term effects in one month and rehospitalization rate and cardiac mortality rate within one year were observed in two groups.Results:After treatment one month,compared with digoxin group,there were significant decrease in rest ventricular rate [(91.6±8.5) times min vs.(72.8±9.7) times min]and ventricular rate difference immediately before and after exercise [(23.1±4.2) times min vs.(12.3±4.7) times min]and significant increase in 6min walking distance [6MWD,(256.4±90.4) m vs.(299.8±94.1) m]in metoprolol + digoxin group,P<0.05 all;Compared with digoxin group after one-year follow-up,there were significant decrease in rehospitalization rate(42.6% vs.19.2%) and mortality rate caused by heart failure(20.4% vs.11.5%),left ventricular end-diastolic volume and left ventricular end-systolic volume;significant increase in 6MWD and left ventricular ejection fraction,and significant improvement in New York heart association class and scores of quality of life in metoprolol + digoxin group,P<0.05 all.Conclusion: Based on routine therapy,digoxin combined with metoprolol possesses more effects than that of digoxin treatment in one month and one year