美托洛尔治疗慢型克山病的效果观察  

Effect of metoprolol on treatment of chronic Keshan disease

作　　者：杨丕俊 牛存龙 王书琨 毕增满 金玲 杨育梅 杨美菊 那丹华 

机构地区：[1]云南省克山病防治研究中心,云南楚雄675000

出　　处：《中国地方病学杂志》2000年第4期298-300,共3页Chinese Jouranl of Endemiology

摘　　要：目的　探讨 β阻滞剂对慢型克山病 (CKD)的近期和远期临床效果。方法　于 1995年起对我们收治的 CKD患者随机配对分组 ,试验组和对照组各组病例 30例。2个组均给予强心、利尿、扩血管等基础治疗 ,试验组在基础治疗前提下 ,选用选择性β1 受体阻滞剂美托洛尔 ,设初始量和维持量 2个阶段。初始量 10～ 12 .5 mg/ d,分 2次 ,连服 7d后改为维持量 2 0～ 2 5 m g/ d,分 2次 ,观察 3周 ,依据观察情况确定个体维持量给予长期服用。结果　心律失常 :试验组恢复率为 10 0 % ,对照组为 82 .6 0 %。射血分数 (EF% ) :治疗前试验组平均值为 (2 6 .0 7± 5 .16 ) % ;对照组为 (2 4.87± 4.43) % ,(t=0 .96 7,P >0 .0 5 )。治疗后试验组 (5 1.13± 7.5 1) % ,对照组 (45 .10± 3.96 ) % ,2个组间 (t=3.89,P <0 .0 1) ,差异有显著意义。心功能级别的改善试验组显著优于对照组。结论　在强心、利尿、扩血管治疗的基础上 ,选用小剂量美托洛尔 10～ 12 .5 mg/ d,治疗慢型克山病则是安全有益的 ,用 2 0～ 2 5 mg/ d可有 5 3.33%的患者出现心衰加重。Objective To study the immediate and forward effect of β-blockers treatment of chronic Keshan disease.Methods Since 1995 sixty patients with chronic Keshan disease treated in my centre were randomty divided into text group (n=30) and control group (n=30).All the patients were treated by cardiotonic,diuretic and vasodilators.The test group was given methoprolol.Treatment had been started with 10~12.5 mg once daily in two doses.After seven days the maintenance doses were 20~25 mg once daily in two doses.After three weeks,the dose was adjusted individually.Results Arrhythmia:the recovery ratio was 100% in test group,82.6% in control group.Ejection fraction (EF%):before treatment the test group was (26.07±5.16)% and the control group was (24.87±4.43)%,(t=0.967,P>0.05);after treatment the test group was (51.13±7.51)%,but the control group was (45.10±3.96)%,(t=3.89,P<0.01).On the improvement of cardiac function the test group was better than the control group.Conclusions In treatment of Keshan disease in addition of cardiotonic,diuretic and vasodilators,small dose of metoprolol (10~12.5 mg) is profitable;53.33% of patients develop (using 20~25 mg) heart failure.

关 键 词：慢性克山病 美托洛尔 药物疗法 疗效 

分 类 号：R542.3[医药卫生—心血管疾病]