美托洛尔对慢性心力衰竭伴慢性心房颤动患者的作用  

Effects of metoprolol in patients with chronic heart failure complicated chronic atrial fibrillation

作　　者：汪顺银[1] 黄德嘉[2] 丁春华[3] 

机构地区：[1]广东省佛山市第二人民医院心血管内二科,广东佛山528000 [2]四川大学华西医院心内科 [3]广东省中医院心内科

出　　处：《心血管康复医学杂志》2012年第4期392-395,共4页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:探讨地高辛联用美托洛尔对慢性心力衰竭(CHF)伴慢性心房颤动(AF)患者的疗效。方法:选择CHF伴慢性AF患者106例,随机分为地高辛治疗组(54例)和美托洛尔+地高辛组(52例),观察两组1月疗效并随访1年期间因心脏原因的再住院率、死亡率。结果:治疗1月后,与地高辛组相比,美托洛尔+地高辛组静息心室率[(91.6±8.5)次/min比(72.8±9.7)次/min]和运动前后即刻心室率差值显著降低[(23.1±4.2)次/min比(12.3±4.7)次/min],6min步行距离显著增加[(256.4±90.4)m比(299.8±94.1)m],P均<0.05;随访1年,与地高辛组相比,美托洛尔+地高辛组因心力衰竭再住院率(42.6%比19.2%)、死亡率(20.4%比11.5%)明显降低,NYHA分级明显改善、6min步行距离明显增加,左室舒张末容积、左室收缩末容积明显减小,左室射血分数明显提高,生活质量明显改善,P均<0.05。结论:在常规用药的基础上,地高辛联用美托洛尔的1月疗效与1年后疗效都明显优于单用地高辛的治疗。Objective： To investigate therapeutic effects of metoprolol combined with digoxin in patients with chronic heart failure（CHF） complicated chronic atrial fibrillation（AF）.Methods： A total of 106 CHF ＋ chronic AF patients were randomly divided into metoprolol ＋ digoxin group（n=52） and digoxin group（n=54）.Short-term effects in one month and rehospitalization rate and cardiac mortality rate within one year were observed in two groups.Results：After treatment one month,compared with digoxin group,there were significant decrease in rest ventricular rate [（91.6±8.5） times min vs.（72.8±9.7） times min]and ventricular rate difference immediately before and after exercise [（23.1±4.2） times min vs.（12.3±4.7） times min]and significant increase in 6min walking distance [6MWD,（256.4±90.4） m vs.（299.8±94.1） m]in metoprolol ＋ digoxin group,P0.05 all;Compared with digoxin group after one-year follow-up,there were significant decrease in rehospitalization rate（42.6% vs.19.2%） and mortality rate caused by heart failure（20.4% vs.11.5%）,left ventricular end-diastolic volume and left ventricular end-systolic volume;significant increase in 6MWD and left ventricular ejection fraction,and significant improvement in New York heart association class and scores of quality of life in metoprolol ＋ digoxin group,P0.05 all.Conclusion： Based on routine therapy,digoxin combined with metoprolol possesses more effects than that of digoxin treatment in one month and one year

关 键 词：美托洛尔 地高辛 心力衰竭 充血性 心房颤动 

分 类 号：R541.61[医药卫生—心血管疾病]