琥珀酸美托洛尔与慢性心力衰竭心功能恢复的相关性研究  

Study on correlation of metoprolol succinate level with recovery of cardiac function in chronic heart failure

作　　者：李慧[1] 任妍[2] 张华[3] 赵建荣[1] 薛文婕 张凤如[2] LI Hui;REN Yan;ZHANG Hua;ZHAO Jianrong;XUE Werijie;ZHANG Fengru(Department of Cardiology,Ruijin Hospital Luu an Branch,Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China;Department of Radioimmunocissay and Clinical Laboratory,Ruijin Hospital Luu an Branch,Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China;Department of Geriatrics. Ruijin Hospital, Shanghai Jiao Tong UniversitySchool of Medicine, Shanghai 200025,China)

机构地区：[1]上海交通大学医学院附属瑞金医院卢湾分院心内科,上海200025 [2]上海交通大学医学院附属瑞金医院老年科,上海200025 [3]上海交通大学医学院附属瑞金医院卢湾分院放免检验科,上海200025

出　　处：《内科理论与实践》2018年第6期344-348,共5页Journal of Internal Medicine Concepts & Practice

摘　　要：目的:探讨琥珀酸美托洛尔血药浓度与慢性心力衰竭(chronic heart failure,CHF)患者心功能恢复的相关性。方法:连续入选2015年1月至2017年12月在多中心就诊的401例诊断为CHF患者,随访患者临床一般情况并定期行超声心动图检测,详细记录患者随访期间琥珀酸美托洛尔剂量的变化;通过高效液相色谱质谱(liquid chromatography-mass spectrometry,HPLC-MS)方法测定CHF患者血浆中琥珀酸美托洛尔血药浓度。采用Logistic回归分析CHF患者琥珀酸美托洛尔血药浓度与心功能恢复及其他因素的相关性。结果:最终资料完整可分析数据患者370例,平均随访(24.5±11.3)个月,93例(25.1%)患者心功能恢复。心功能恢复组患者的琥珀酸美托洛尔血药浓度与所服用的最大耐受琥珀酸美托洛尔剂量呈正相关性(r=0.701, P<0.05);所测定的血药浓度与患者预后呈正相关性(r=0.336, P<0.05)。多变量Logistic回归分析结果显示,可耐受的琥珀酸美托洛尔剂量越大的患者,血药浓度越高,心功能更易恢复(P<0.05)。结论:CHF患者血浆中琥珀酸美托洛尔血药浓度与所服用的琥珀酸美托洛尔剂量和心功能恢复相关,临床上可使用该方法来监测患者服药情况,并评估CHF患者预后。Objective To study the correlation of plasma level of metoprolol succinate with recovery of cardiac function in patients with chronic heart failure(CHF).Methods A total of 401 patients with CHF from January 2015 to December2017 were enrolled.Clinical features and biochemical data were recorded,and echocardiography was performed at regular intervals.The details of metoprolol succinate usage and doses administered were recorded.Plasma metoprolol succinate level was detected by liquid chromatography-mass spectrometry(HPLC-MS).Logistic regression analysis was performed to assess the relationship between plasma level of metoprolol succinate and recovery of cardiac function.Results A total of370 CHF patients were enrolled in this study.During a median follow-up period of(24.5±11.3)months,93 patients(25.1%)had cardiac function recovered.A positive correlation was found between plasma level of metoprolol succinate and dosage of drug(r=0.701,P<0.05),and a positive correlation between plasma level of metoprolol succinate and recovery of cardiac function(r=0.336,P<0.05).Multivariant Logistic regression analysis showed that patients who tolerated the more doses had the higher blood level and got better recovery of cardiac function.Conclusions In CHF patients,recovery of cardiac function is positively correlated with the plasma level of metoprolol succinate and the dosage of drug.In clinical practice,it can be used for monitoring the administration of drug and predicting the prognosis of CHF patients.

关 键 词：慢性心力衰竭 琥珀酸美托洛尔 高效液相色谱质谱 血药浓度 心功能恢复 

分 类 号：R541.6[医药卫生—心血管疾病]