美托洛尔治疗老年慢性心力衰竭的疗效及安全性.doc

1 美托洛尔治疗老年慢性心力衰竭的疗效及安全性【摘要】目的评价β拟受体阻滞剂治疗老年慢性心力衰竭的疗效及安全性。方法 107 例老年慢性心力衰竭患者按就诊顺序随机分为两组,美托洛尔 53 例在常规抗心力衰竭治疗基础上加用美托洛尔 ~ 25mg ,2次/d ;对照组 54 例采用常规抗心力衰竭治疗, 未用美托洛尔。定期来诊随访, 以观察临床表现, 监测治疗前后心率、血压、心功能参数变化。结果美托洛尔显效率 % ,总有效率 % ;对照组显效率 % ,总有效率 % ,两者比较有显著性差异( P< ) 。美托洛尔组患者心率减慢、血压降低较对照组明显, 超声心动图复查显示治疗 6 个月后左室舒张末期内径缩小,左室射血分数增高较对照组显著。结论美托洛尔对老年慢性心力衰竭是一种较为安全有效的药物。【关键词】心力衰竭美托洛尔老年 Clinical Effect of Metoprolol on Elderly Patients with Chronic Heart Failure and its Safety 2 Rui LEi, Liu Jia 拟 xing, Li Jian 拟 chun (Department of Cardiology, PLA Hospital, Quanzhou 362000, China) Abstract : Objective To evaluate the clinical effect of metoprolol on elderly patients with chronic heart failure and its safety. Methods A total of 107 elderly patients with chronic heart failure were allocated into metoprolol group (n=53) and control group (n=54) at random. The patients in the metoprolol group were treated with metoprolol (-25mg, twice per day) and the patients in the control group were only given routine treatment without metoprolol. The changes in heart rate, blood pressure, heart function and echocardiography were observed before and after treatment. Results The effective rate and total effective rate in the metoprolol group were % and %, and the counterparts were % and % in the control group, respectively (P< ). After the treatment lasting months, not only the heart rate and the blood pressure in the metoprolol group were lower than that in the control group, but the heart function and the indexes of echocardiography (LVEF, 3 LVDD) were obviously improved as well. Conclusion Metoprolol can served as an effective and safe agent for the treatment of the elderly patients with chronic heart failure. Key words : heart failure; metoprolol; elderly 按传统理论,β拟受体阻滞剂可能阻断心脏β1拟受体而抑制心肌收缩, 导致原有的心力衰竭恶化, 因而以往的药典常将心力衰竭列为β拟受体阻滞剂的禁忌证之一。然而, 随着临床实践的逐步深入以及对心力衰竭病理生理认识的进一步加深,人们的观念正发生着巨大变化, β拟受体阻滞剂在慢性充血心力衰竭患者治疗中的地位越来越引起人们的关注。我们通过对美托洛尔治疗老年慢性心力衰竭患者的 6 个月随访观察, 并与未服β拟