琥珀酸美托洛尔缓释片对老年慢性心力衰竭合并慢性阻塞性肺疾病患者肺功能的影响  

Effect of Metoprolol Succinate Sustained Release Tablets on Pulmonary Function of the Elderly with the Combination of COPD and Chronic Heart Failure

作　　者：朱华[1] 史凯蕾[1] 宫玲[1] 朱菲白[1] 徐红[1] Zhu Hua;Shi Kailei;Gong Ling;Zhu Feibai;Xu Hong(Department of Cardiology,Huadong Hospital Affliliated to Fudan University,Shanghai,200040,P.R.China)

机构地区：[1]复旦大学附属华东医院心血管内科,上海200040

出　　处：《老年医学与保健》2018年第3期243-246,共4页Geriatrics & Health Care

基　　金：上海市卫生和计划生育委员会面上课题(201540292)

摘　　要：目的探讨靶剂量(心率达到60次/分或者较起始心率下降20次/分以上)琥珀酸倍他乐克缓释片对老年心衰合并慢性阻塞性肺病患者心功能的改善及肺功能的影响。方法选择2015年7月—2016年3月43例老年左室收缩功能降低心衰合并COPD患者,给予小剂量琥珀酸倍他乐克缓释片起始治疗,根据心率和症状体征,逐步增加剂量直到靶剂量,并持续观察6个月。观察并比较治疗前后患者症状体征、左室射血分数(LVEF)、6分钟步行试验(6-MT)、血压及肺功能(FEV1、FEV1/预测值%、FVC、FEV1/FVC(%))变化情况。结果老年左室收缩功能降低心衰合并COPD患者应用靶剂量琥珀酸倍他乐克缓释片治疗6个月后,心功能分级(1/2/3级)治疗前分别为(0/8/32)例,治疗后分别为(10/22/8)例,治疗后较治疗前明显改善(P<0.01);6-MT从(246.18±70.96)m提高到(282.83±71.23)m,较治疗前明显改善(P<0.01);但LVEF值、COPD分级及肺功能指标治疗前后无明显差异(P>0.05)。结论靶剂量琥珀酸倍他乐克缓释片对改善老年心衰合并COPD患者心衰症状是有效的;维持靶剂量琥珀酸倍他乐克缓释片不会加重老年心衰合并COPD患者肺功能的减退。Objective To observe the effect of target dose of metoprolol succinate sustained release tablets on cardiac function improvement and pulmonary function of the elderly with the combination of COPD and chronic heart failure. Methods From July, 2015 to March, 2016, 43 elderly with heart failure with reduced ejection fraction combined with COPD were randomly selected and began to receive the treatment with metoprolol succinate sustained release tablets of the minimum dose;based on the heart rate, clinical symptoms and signs, the initial dose was kept increasing till to the target dose; observation was made to the clinical symptoms and signs, LVEF, 6-MT, blood pressure and pulmonary function（FEV1, FEV1/predicted value %, FVC, FEV1/FVC（%）） of the elderly and a comparative study was made to the changes after treatment. Results Based on NYHA, before treatment, the case number in grading I, II and III was 0, 8 and 32, respectively while after the treatment, the case number changed to 10, 22 and 8, respectively, the change was of obvious statistical significance（ P0.01）;6-MT increased from（246.18±70.96）meters to（282.83 ±71.23） meters（ P0.01）; the LVEF indexes, COPD grading and pulmonary function indices of the elderly after treatment were of no statistical difference from those before treatmentare（P 0.05）.Conclusions Target dose of metoprolol succinate sustained release tablets is effective in improving the symptoms of heart failure in the elderly with the combination of COPD and chronic heart failure; maintaining the target dose of metoprolol succinate sustained release tablets will not deteriorate pulmonary hypofunction.

关 键 词：老年 慢性心衰 慢性阻塞性肺疾病 琥珀酸倍他乐克缓释片 肺功能 

分 类 号：R541.6[医药卫生—心血管疾病] R563.9[医药卫生—内科学]