| 引用本文： |
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谢赟,蒋金法.美托洛尔缓释片治疗左室射血分数保留的心力衰竭的疗效观察[J].同济大学学报（医学版）,2012,33(4):78-82. [点击复制]
- XIE Yun,JIANG Jin-fa.Metoprolol extended-release tablets in treatment of heart failure with preserved ejection fraction[J].同济大学学报（医学版）,2012,33(4):78-82. [点击复制]
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| 摘要: |
| 目的 观察美托洛尔缓释片对左室射血分数保留的心力衰竭(heart failure with preserved ejection fraction,HFpEF)患者心功能的改善作用。方法 入选HFpEF患者133例,随机分成美托洛尔缓释片治疗组69例及对照组64例,两组患者均给予抗心力衰竭的常规治疗,但对照组不用β-受体阻滞剂。治疗组接受美托洛尔缓释片,随访12个月。比较两组患者治疗前后血压、心率及心超左室舒张功能等的变化。并比较小剂量美托洛尔缓释片组[(47.5±10)mg/d,(n=29)]及大剂量组[(95±20)mg/d,(n=40)]对心功能的改善情况及对血压、心率的影响。结果 治疗组左室射血分数(left ventricular ejection fraction,LVEF)升高、左室舒张末期内径(left ventricular enddiastolic diameter,LVEDD)缩小、收缩压、舒张压降低(P＜0.05),NT-pro-BNP浓度、心率明显下降(P＜0.01)。治疗组12个月后左室等容舒张时间(isovolumic relaxation time,IVRT)、左室早期充盈减慢指标E峰、A峰、E/A,以及左房内径(left atrial diameter,LAD)等左室舒张功能指标优于治疗前(P＜0.01),并优于对照组(P＜0.01)。大剂量美托洛尔缓释片治疗组在治疗12个月后较小剂量治疗组心率、NT-pro-BNP浓度显著下降(P＜0.01)。结论 美托洛尔缓释片治疗HFpEF可显著改善左室舒张功能。大剂量比常规剂量更进一步抑制神经激素的过度激活,尤其降低NT-pro-BNP浓度,更充分发挥生物学效应。 |
| 关键词: 美托洛尔缓释片 左室射血分数保留的心力衰竭 疗效 |
| DOI：10.3969/j.issn1008-0392.2012.04.017 |
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| 基金项目: |
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| Metoprolol extended-release tablets in treatment of heart failure with preserved ejection fraction |
| XIE Yun1,JIANG Jin-fa2 |
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| Abstract: |
| Objective To evaluate the efficacy of metoprolol ex tended -^elease tablets in treatment of heart failure with preserved ejection fraction (HFpEF) . Methods One hundred and thirty three patients with HFpEF were randomly assigned to receive conventional therapy and metoprolol extended-release tablets (metoprolol group，n=69) or receive conventional therapy only ( control group， n=64) . The blood pressure，heart rate，left ventricular diastolic function were compared between the two groups. The metoprolol group was further divided into low-do sage treated group [(47.5±10) mg/d，n=40] and high-dosage group [(95±20) mg/d， n=29] . Results Left ventricular ejection fraction (LVEF)， left ventricular end diastolic diameter (LVEDD)， blood pressure， heart rate and N-terminal pro -brain natriuretic peptide (NT-pro-BNP) levels were improved significantly 12 months after treatment in the metoprolol group，there were significantly differences between metoprolol and control groups (P＜0.05， P＜0.01) . The isovolumic relaxation time (IVRT)， early left ventricular filling velocity (E)，velocity of left ventricular filling contributed by atrial contraction (A)， E/A and left atrial diameter ( LAD) after treatment were better than those before treatments (P＜0.01)，and also better than those in control group (P＜0.01) . Compared to those in low-dosage group，heart rate and plasma NTproBNP concentration in high-dosage group were significantly improved (P＜0.01 ). Conclusion Metoprolol extended-release tablets can improve the heart diastolic function in patients with HFpEF; and high-dosage metoprolol may inhibit the over-activation of neural hormones and further improves biological efficacy. |
| Key words: metoprolol sustained- release tablets heart failure with preserved ejection fraction effect |
