美托洛尔治疗慢性充血性心力衰竭的疗效观察

目的：观察美托洛尔（倍他乐克）治疗慢性充血性心力衰竭的临床疗效。方法：选择慢性充血性心力衰竭患者72例，在常规治疗后病情基本稳定的基础上，随机分为对照组34例，给予强心甙、利尿剂、血管扩张剂和血管紧张素转换酶抑制剂治疗；美托洛尔组38例，在对照组治疗基础上加用美托洛尔，初始剂量6．25mg，每日2次，每2周递增1次剂量，为上述剂量的2倍，直至最大耐受剂量50mg，每日2次，维持治疗3个月以上。结果：美托洛尔组的心功能改善显效率为44．7％，总有效率为89．4％，高于对照组的26．5%和64．7％，总有效率差异有显著性（P〈0．05）。与治疗前相比，美托洛尔组心率、血压、左心室射血分数、左心室舒张末期内径均有显著改善（P均〈0．05），疗效优于对照组（P〈0．05）。结论：在常规治疗基础上，加用美托洛尔治疗慢性充血性心力衰竭安全有效。可以显著改善左室重构。

Therapeutic effect of metoprolol in patients with chronic congestive heart failure

Objective： To study the therapeutic effect of metoprolol in patients with chronic congestive heart failure. Methods： A total of 72 patients with congestive heart failure （CHF） were randomly divided into routine therapy group （control group, 34 cases, treated with routine therapy） and metoprolol group （38 cases, treated with metoprolol above the base of therapy in control group）. The metoprolol start dose was 0. 25mg, increased dose every two weeks, until 50mg, two tirnes/d and continued three months in metoprolol group. Results： The excellence rate was 44.7%, and the total effective rate was 89.4 % in metoprolol group, its were more than those of control group （26.5 %, 64.7 %, P〈0.05）. The heart rate, blood pressure, left ventricular ejection fraction （LFEF） and left ventricular end--diastolic dimension （LVEDD） significantly improved after therapy in metoprolol group, the improve of heart rate, blood pressure and LVEF were more than those of control group （P〈0.05）. Conclusion： Therapeutic of metoprolol above the routine therapy is effective and safety, may improve cardiac ventricular remodeling.