美托洛尔治疗慢性心力衰竭临床疗效观察.docVIP

美托洛尔治疗慢性心力衰竭临床疗效观察[摘要] 目的:评价美托洛尔对慢性心力衰竭患者心功能及血浆脑钠肽(BNP)的影响。方法:将70例慢性心力衰竭患者随机分为对照组35例和治疗组35例,对照组给予地高辛、利尿剂、血管紧张素转换酶抑制剂或血管紧张素Ⅱ受体拮抗剂治疗,治疗组在此基础上加用美托洛尔。观察治疗前及治疗结束后患者的心功能及BNP变化。结果:与治疗前相比,治疗组的左心室短轴缩短率(LVFS)、左心室射血分数(LVEF)、BNP值明显改善;与对照组比较,治疗组的临床疗效显效率和总有效率均较高,且LVFS、LVEF、BNP值差异显著。结论:美托洛尔能改善慢性心力衰竭患者的心功能,且安全有效。 [关键词] 美托洛尔;心力衰竭;脑钠肽 [中图分类号]R541.6 [文献标识码]B [文章编号]1673-7210(2010)04(a)-110-02 Observation of clinical effect of Metoprolol in the treatment of chronic heart failure JIN Xia (Department of Cardiology,Shenzhou Hospital,Shenyang Medical Univercity,Shenyang 110002, China) [Abstract] Objective: To evaluate the effects of Metoprolol on the heart function and brain natriuretic peptide in chronic heart failure patients. Methods: 70 patients with chronic heart failure were divided into control group (35 patients) and therapy group (35 patients). The control group patients were given basic treatment with Digoxin, Diuretics, Angiotensin converting enzyme inhibitor (ACEI) or Angiotensin II receptor blocker(ARB); the therapy group were given Metoprolol in addition to the basic treatment. Heart function and BNP level in chronic heart failure patients was observed before and after treatment. Results: After treatment, BNP level, left ventricular ejection fraction(LVEF) and left ventricular diameter (LVFS) were obviously improved for therapy group. Compared with control group, the excellence rate and total effective rate increased significantly, BNP level decreased and LVEF and LVFS increased in therapy group. Conclusion: Metoprolol can be used improve the heart function in chronic heart failure patients, and it is effective and safe. [Key words] Metoprolol; Heart failure;Brain natriuretic peptide 慢性心力衰竭(CHF)是各种心脏病最终的共同归宿,随着中国步入老龄化社会,心血管疾病的发病逐年增加,心力衰竭的治疗越来越受到临床医生的重视。近年来人们已经认识到CHF的发生与肾素-血管紧张素系统(RAS)和交感神经系统(SNS)过度激活、心肌重塑有关。因此,阻断神经激素的过度激活、阻断心肌重塑是治疗CHF的关键。β受体阻滞剂不仅能改善心衰症状,且能防止和延缓心室重塑的发展。本研究在常规抗心衰治疗的基础上加用美托洛尔治疗CHF患者,观察其对心功能指标、血浆脑钠肽(BNP)水平的影响,评估美托洛尔对CHF的临床疗效。 1 资料与方法