小剂量美托洛尔治疗重症心力衰竭的疗效观察

目的观察小剂量美托洛尔治疗重症心力衰竭的临床疗效。方法选择2011年1月至2013年1月我院心内科收治的108例重症心力衰竭患者,采用随机数字表法分为观察组和对照组,各54例。对照组给予常规治疗,观察组在常规治疗的基础上,同时给予小剂量美托洛尔(6.25²5 mg/d)。完成治疗计划后,比较两组患者的临床疗效,以及左心室舒张末期内径(LVD)、收缩末期内径(LVS)和射血分数(LVEF)等心功能指标。结果观察组患者治疗显效率53.7%和总有效率81.5%明显高于对照组显效率22.2%和总有效率61.1%,差异有统计学意义(χ2=11.362,P=0.001;χ2=5.637,P=0.016)。治疗前两组患者的LVD、LVS和LVEF等心功能指标比较,差异无统计学意义(均为P>0.05)。治疗后观察组患者的LVD为(58.6±7.2)mm、LVS为(37.5±8.8)mm和LVEF为56.7%±6.4%,明显优于对照组的(61.8±9.8)mm、(41.7±9.3)mm和52.5%±6.9%,差异均有统计学意义(t=1.934、2.411和3.279,均为P<0.05)。结论在本研究样本人群中,小剂量美托洛尔治疗重症心力衰竭,提高了临床疗效,改善了患者心功能,并且安全性较好。

Clinical effect of small dose of metoprolol in the treatment of severe heart failure

Objective To observe the clinical effect of small dose of metoprolol in the treatment of severe heart failure. Methods The 108 patients with severe heart failure treated in our hospital from Jan. 2011 to Jan. 2013 were chosen as the research object, which were divided into observation group and control group according to random number table. The observation group： 54 cases were treated with small dose （6. 25-25 mg/d） of metoprolol on the basis of conventional treatment. And the control group： 54 cases were treated with conventional treatment. The clinical effect, diastolic diameter （LVD）, systolic diameter （LVS） and left ventricular ejection fraction （ LVEF ） were compared in the two groups. Results The markedly effective rate （53.7%） and total effective rate （81.5%） were much higher in the observation group than these in the control group 22.2% and 61. 1% , and the difference was statistically significant （X2 = 11. 362, P=0. 001;X2 = 5. 637, P = 0. 016）. Before treatment, it was not statistically significant of difference between the two groups on the LVD, LVS and LVEF （ all P 〉 0. 05）. After treatment, the LVD was （58.6±7.2） mm, LVS was （37.5 ±8.8） mm and LVEF was 56.7% ±6.4%, were much better in the observation group than these [ LVD was （61.8 ± 9. 8 ） mm, LVS was （41.7±9.3 ） mm and LVEF was 52. 5% ± 6. 9% ] in the control group, and the difference was statistically significant （ t = 1. 934, 2.411 and 3. 279, all P 〈 0. 05 ）. Conclusions It＇s good for severe heart failure to improve clinical effect and heart function by treating with small dose of metoprolol.