美托洛尔对心脏储备功能的临床影响  

The clinical effects of metoprolol on the cardiac reserve of cardiovascular patients

作　　者：刘天虎[1] 许锋成 晏明君 曾洪燕[1] 尹小华[1] 陈蓉[1] 李学林[2] 刘剑雄[3] 

机构地区：[1]四川省郫县人民医院,四川成都611730 [2]四川省大邑县人民医院 [3]成都市第三人民医院

出　　处：《中国民康医学》2010年第3期241-242,245,共3页Medical Journal of Chinese People’s Health

基　　金：四川省卫生厅科研资助课题(编号060205)

摘　　要：目的:了解β受体阻滞剂对左心室功能特别是心脏储备的影响。方法:把120位心血管病患者分为卡托普利组和卡托普利合用美托洛尔组治疗6个月,治疗前后应用超声心动图(UCG)测定左室舒张末期内径(LVDd)、舒张末期室间隔厚度(IVSd)、舒张末期左室后壁厚度(LVPWd)、左室射血分数(LVEF)、二尖瓣舒张早期最大峰值流速E峰(VE)和舒张晚期最大峰值流速A峰(VA)、左心室心肌重量(LVM),应用心音图运动试验(PCGET)测定运动前后第一心音幅值(S1),运动前后心率、6分钟步行试验步行的距离、心力储备指数(CCRI)和心脏储备指数(CRI)。结果:治疗前后比较,两组LVDd、IVSd、LVPWd较前明显减少(P(0.05),LVEF明显增加(P(0.05),LVM明显下降(P(0.01),静息心率下降和运动后心率增加(P(0.05),6分钟步行距离增加(P(0.05),CCRI和CRI明显增加(P(0.01),并且卡托普利合用美托洛尔组的LVDd减少、LVEF增加、6分钟步行距离增加、CRI明显增加,较单用卡托普利组更为显著(P(0.05)。结论:ACEI能改善左心室收缩功能和舒张功能,CCRI、CRI增加,改善心脏储备功能;如ACEI和β受体阻滞剂合并使用,β受体阻滞剂能够更明显地改善患者左心室功能,使患者心脏储备功能进一步改善,明显提高患者的生存质量。Objective：To be aware of the effects of Metoprolol on the left ventricular function, especially the effects on cardiac reserve. Methods： One hundred and twenty cardiovascular patients were divided into Captopril group and combined treatment group （ metoprolol ＋ captopril） and treated for 6 months. Left ventricular end - diastolic internal dimension （ LVDd）, end - diastolic interventficular septum thickness（IVSd） , end -diastolic posterior LV wall thickness （LVPWd） , LV ejection fraction（LVEF） , peak early diastolic mitral flow velocity（VE） and peak late diastolic mitral flow velocity（VA） , and left ventrieular mass（ LVM ）were measured by ultrasound cardiogram（UCG） before and after treatment. The amplitude of the first heart sound （S1）and heart rate （HR）before and following exercise, distance for 6 -rain walking test, cardiac contractility reserve index（ CCRI）, and cardiac reserve index（CRI） were measured by phonocardiogram exercise test. Results： In both groups, LVDd ,IVSd and LVPWd were significantly decreased after the treatment（ P 〈 0. 05 ）, LVEF significantly increased （ P 〈 0.05 ）, LVM significantly decreased （ P 〈 0.01 ）, rest HR decreased and HR following exercise increased （P 〈 0.05 ）, distance for 6 - rain walking test increased （P 〈 0.05 ）, and CCRI, CRI significantly increased（ P 〈 0.01 ）. Moreover, when compared with that in the Captopril group, the changes in the combined treatment group （Meto- prolol ＋ Captopril） turned out to be even more significant： LVDd were decreased, LVEF increased, distance for 6 - min walking test increased, CRI significantly increased （P 〈 0.05 ）. Conclusions： Captopril can help improve the contraction and relaxation of left ventrieular, reverse LV remodeling,enhance exercise capacity, increase CCRI, CRI and improve cardiac reserve. Metoprolol when combined with Captopril can enhance the function of left ventricular even more significantly, further promote the car

关 键 词：美托洛尔 卡托普利 心脏储备 

分 类 号：R972.4[医药卫生—药品]