美托洛尔治疗慢性心力衰竭的临床观察

目的 观察琥珀酸美托洛尔缓释片治疗慢性心力衰竭的有效性和安全性.方法 将71例慢性心力衰竭患者随机分成治疗组(n=36)和对照组(n=35).治疗组在常规治疗的基础上口服美托洛尔缓释片(起始量11.875mg/d,每2周剂量加倍,靶剂量95mg/d),对照组按常规治疗,疗程6个月.观察治疗前后心率、左室舒张末期内径、左室射血分数和6min步行距离.结果 治疗组2个月后气促症状明显改善、心率明显下降(95.0±7.8)次/min、(86.4±8.1)次/min,P<0.05];4个月后左室射血分数(29.9±7.7)%、(44.8±7.8)%,P<0.05]和6min步行距离明显改善(228.8±46.0)m、(387.9±47.7)m,P<0.05],6个月后治疗组左室射血分数(47.5±8.2)%和6min步行距离(512.8±58.0)m进一步改善(P<0.01),左室舒张末期内径明显缩小(65.7±9.O)mm、(54.5±8.9)mm,P<0.05],与对照组比较心率(82.7±8.4)次/min明显下降(P<0.05),左室射血分数(41.0±8.9)%和6min步行距离(418.8±54.3)m明显改善(P<0.05),治疗有效率明显增加(93.9%、68.6%,P<0.01).结论 美托洛尔缓释片治疗慢性心力衰竭安全有效.

Sustained release metoprolol succinate for patients with chronic heart failure

Objective To investigate the efficacy and safety of sustained release metoprolol succinate (short for metoprolol) for patients with chronic heart failure. Methods 71 stable patients with chronic heart failure were randomly divided into metoprolol group (n=36) and placebo (n=35), once daily metoprolol ( initial daily dose, 11.875mg, double every 2 weeks, target dose 95mg once daily) was given to metoprolol group. The heart rate, left ventricular ejection fraction (LVEF), left ventricular end diastolic diameter (LVEDd) and 6-min walking distance were observed. Results 2 months after the initiation of metoprolol treatment, dyspnea improved, heart rate reduced significantly(P< 0.05); 4 months after treatment, left ventricular ejection fraction and 6-min walking distance improved significantly (P<0.05 and P< 0.01) after 6 months; 6 months after treatment, left ventricular end diastolic diameter reduced significantly (P<0.05). In placebo group, heart rare reduced significantly (P<0.05) 4 months after treatment, 6 months after treatment, left ventricular ejection fraction and 6-min walking distance improved significantly (P<0.05), left ventricular end diastolic diameter reduced, but it was not significant (P0.05). Compared with placebo, composite end points (rehospitalization, cardiovascular mortality and total mortality) in metoproiol group reduced significantly (P<0.05). Conclusion Sustained release metoprolol succinate is effective mad safe for patients with chronic heart failure.