美托洛尔治疗慢性充血性心力衰竭86例临床体会

目的:了解慢性充血性心力衰竭(CHF)患者在常规治疗的基础上加用β受体阻滞剂的疗效和副作用。方法:选择病因不同的CHF患者86例,在常规应用利尿剂、ACEI、洋地黄和(或)硝酸酯制剂治疗的基础上,加用β受体阻滞剂美托洛尔(治疗组),与同期按常规治疗的86 例CHF患者(对照组),比较两组的疗效;在治疗后1 个月、3个月、6 个月比较两组患者临床指标:心率、血压、心功能、左室射血分数( LVEF)、左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)及左房内径(LADD)的改变。结果:两组患者在治疗3个月后心率、心功能及LVEF均较治疗前有明显改善(P<0.01或P<0.05),但治疗组较对照组改善更为显著,两组比较有显著性差异(P<0.05);同时治疗组3 个月后LVEDD、LVESD、LADD均较治疗前改善,有显著性差异(P< 0. 01 或P<0.05),而对照组无改善。结论:在常规治疗CHF的基础上加用美托洛尔可以明显改善心功能,增加LVEF,改善心室重塑,提高治疗CHF的疗效。

Clinical Observation on 86 Cases of Chronic Congestive Heart Failure Treated by Metoprolol

Objective: To investigate the therapeutic effect of metoprolol on chronic congestive heart failure(CHF).Methods:Eighty-six patients with CHF were randomly divided into treatment group and control group.The patients in control group received routine treatment including diuretic, angiotension converting enzyme inhibitors(ACEI),digitora and vessel dilator.The patients in treatment group was administrated with metoprolol in addition to the medicines used in control group.After treating for 1 month,3 months and 6 months, the clinical marker such as heart rate,blood pressure,cardiac function, left ventricular eject fraction(LVEF),left ventricular enddiastolic diameter(LVEDD),left ventricular end systolic diameter(LVESD)and left artium diameter(LADD)were measured in both groups.Results:After treating for 3 months, the heart rate,cardiac function and LVEF were improved markedly(P<0.01 or P<0.05),but the treatment group had more marked improvement and there were significant differences between the two groups(P<0.05);The clinic markers of the treatment group,such as LVEDD,LVESD and LADD were improved markedly after treating for 3 months and there were significant differences between before and after treatment(P<0.01 or P<0.05),whereas that of the control group had no improvement.Conclusion:Metoprolo treatment combines with the routine treatment can obviously improve the patient's cardiac function and LV remodeling,increase LVEF and the therapeutic effect on CHF.