扩张性心肌病心力衰竭的临床治疗及预后研究(1)
摘要：目的 探讨美托洛尔两种剂型治疗扩张性心肌病(Dilated Cardiomyopathy，DCM)心力衰竭的效果。方法 选取在我院就诊的扩张性心肌病心力衰竭患者90例，将其随机分为两组，各45例。对照组口服美托洛尔平片，观察组口服美托洛尔缓释片，对比分析两组的临床疗效、心衰指标及不良反应。结果 对照组的治疗总有效率为80.00%，明显低于观察组的95.56%，差异显著(P<0.05)；治疗后两组NT-pro-BNP、LVEDD及LVEF均比治疗前改善，但观察组比对照组改善明显，差异显著(P<0.05)；对照组的不耐受发生率为22.22%，明显高于观察组的6.67%，差异显著(P<0.05)。结论 给予DCM心衰患者美托洛尔缓释剂型片的治疗效果显著，可有效抑制患者的心肌重构，明显改善心功能，促进预后，且不良反应少。
关键词：扩张性心肌病；心力衰竭；预后
中图分类号：R542.2 文献标识码：A 文章编号：1006-1959(2017)17-0065-02 Clinical Treatment and Prognosis of Dilated Cardiomyopathy with Heart Failure
, 百拇医药
LIU Gang
(Jiajiang Rehabilitation Hospital of Leshan City，Leshan 614100，Sichuan，China)
Abstract：Objective To investigate the effect of metoprolol on two forms of congestive heart failure in patients with dilated cardiomyopathy(Dilated， Cardiomyopathy，DCM).Methods In our hospital 90 cases of dilated cardiomyopathy patients with heart failure were randomly divided into two groups， 45 cases in each group.The control group received metoprolol tablet，and the observation group received metoprolol sustained-release tablets.The clinical efficacy，heart failure index and adverse reactions of the two groups were compared and analyzed.Results The treatment group total effective rate was 80.00%，significantly lower than those in the observation group 95.56%，significant difference(P<0.05)；After treatment，the two groups of NT-pro-BNP，LVEDD and LVEF were better than before treatment，but the observation group was significantly improved compared with the control group， the difference was significant(P<0.05)；The control group intolerance rate was 22.22%，significantly higher than the observation group 6.67%，significant difference(P<0.05).Conclusion The therapeutic effect of metoprolol sustained release tablet for DCM patients with congestive heart failure is significant，which can effectively inhibit the myocardial remodeling，improve the heart function， promote the prognosis，and have less adverse reactions.
, http://www.100md.com
Key words：Dilated cardiomyopathy；Heart failure；Prognosis
擴张型心肌病主要的特点是右心室或左心室明显扩大，且伴有心肌不同程度的肥厚[1]。心力衰竭是DCM的临床常见症状，若其治疗无效或病情不断进展，可严重危及患者生命安全。近年来β-受体阻滞剂已应用于抗心衰的治疗方案中，且取得了一定的疗效。但是其药效所引起的低血压、慢心律等情况，易降低患者耐药性，影响疗效[2]。因此，选择何种安全、有效的β-受体阻滞剂是目前医生及患者所关注的重点。因此，本研究探讨了美托洛尔两种剂型治疗扩张性心肌病心力衰竭的效果，结果报道如下。
1 资料与方法
1.1一般资料
选取2014年2月～2016年1月在我院就诊的扩张性心肌病心力衰竭患者90例，将其随机分为观察组和对照组，各45例。对照组男23例，女22例，平均年龄(61.5±5.5)岁，平均病程(3.3±0.5)年。观察组男24例，女21例，平均年龄(61.2±5.0)岁，平均病程(3.5±0.6)年。排除标准：严重心肝肾疾病者；明显低血压、哮喘及心动过缓者；精神疾病者；伴有其他原因导致的心力衰竭疾病者。两组一般资料对比，无明显差异(P>0.05)。, http://www.100md.com(刘刚)
关键词：扩张性心肌病；心力衰竭；预后
中图分类号：R542.2 文献标识码：A 文章编号：1006-1959(2017)17-0065-02 Clinical Treatment and Prognosis of Dilated Cardiomyopathy with Heart Failure
, 百拇医药
LIU Gang
(Jiajiang Rehabilitation Hospital of Leshan City，Leshan 614100，Sichuan，China)
Abstract：Objective To investigate the effect of metoprolol on two forms of congestive heart failure in patients with dilated cardiomyopathy(Dilated， Cardiomyopathy，DCM).Methods In our hospital 90 cases of dilated cardiomyopathy patients with heart failure were randomly divided into two groups， 45 cases in each group.The control group received metoprolol tablet，and the observation group received metoprolol sustained-release tablets.The clinical efficacy，heart failure index and adverse reactions of the two groups were compared and analyzed.Results The treatment group total effective rate was 80.00%，significantly lower than those in the observation group 95.56%，significant difference(P<0.05)；After treatment，the two groups of NT-pro-BNP，LVEDD and LVEF were better than before treatment，but the observation group was significantly improved compared with the control group， the difference was significant(P<0.05)；The control group intolerance rate was 22.22%，significantly higher than the observation group 6.67%，significant difference(P<0.05).Conclusion The therapeutic effect of metoprolol sustained release tablet for DCM patients with congestive heart failure is significant，which can effectively inhibit the myocardial remodeling，improve the heart function， promote the prognosis，and have less adverse reactions.
, http://www.100md.com
Key words：Dilated cardiomyopathy；Heart failure；Prognosis
擴张型心肌病主要的特点是右心室或左心室明显扩大，且伴有心肌不同程度的肥厚[1]。心力衰竭是DCM的临床常见症状，若其治疗无效或病情不断进展，可严重危及患者生命安全。近年来β-受体阻滞剂已应用于抗心衰的治疗方案中，且取得了一定的疗效。但是其药效所引起的低血压、慢心律等情况，易降低患者耐药性，影响疗效[2]。因此，选择何种安全、有效的β-受体阻滞剂是目前医生及患者所关注的重点。因此，本研究探讨了美托洛尔两种剂型治疗扩张性心肌病心力衰竭的效果，结果报道如下。
1 资料与方法
1.1一般资料
选取2014年2月～2016年1月在我院就诊的扩张性心肌病心力衰竭患者90例，将其随机分为观察组和对照组，各45例。对照组男23例，女22例，平均年龄(61.5±5.5)岁，平均病程(3.3±0.5)年。观察组男24例，女21例，平均年龄(61.2±5.0)岁，平均病程(3.5±0.6)年。排除标准：严重心肝肾疾病者；明显低血压、哮喘及心动过缓者；精神疾病者；伴有其他原因导致的心力衰竭疾病者。两组一般资料对比，无明显差异(P>0.05)。, http://www.100md.com(刘刚)
参见：首页 > 医疗版 > 疾病专题 > 心血管科 > 心力衰竭