不同β受体阻滞剂治疗抗肾上腺素能β1受体抗体阳性的扩张型心肌病临床疗效比较  

Comparison of clinical efficacy of different β receptor blockers in the treatment ofanti-β1AR antibody-positive dilated cardiomyopathy

作　　者：朱彬[1] 邱厚兵 ZHU Bin;QIU Hou-bing(Department of Cardiology,Luzhou Traditional Chinese Medicine Hospital,Luzhou 646000,China;Department of Clinical Laboratory,Luzhou Traditional Chinese Medicine Hospital,Luzhou 646000,China)

机构地区：[1]四川省泸州市中医医院心血管内科,四川泸州646000 [2]四川省泸州市中医医院检验科,四川泸州646000

出　　处：《实用医院临床杂志》2022年第3期78-82,共5页Practical Journal of Clinical Medicine

基　　金：西南医科大学-泸州市中医医院基地项目(编号:2018-LH016)。

摘　　要：目的探讨不同种类β受体阻滞剂应用于抗肾上腺素能β1受体(β1AR)抗体阳性的扩张型心肌病治疗效果的区别。方法选取2018年12月至2020年2月在泸州市中医医院就诊的抗β1AR抗体阳性扩张型心肌病患者160例,随机数字表法分为A、B、C、D四组各40例。四组患者均根据指南行标准化治疗,其中A组口服卡维地洛片,B组口服富马酸比索洛尔片,C组口服酒石酸美托洛尔片,D组口服琥珀酸美托洛尔缓释片,治疗12个月。治疗后6、12月进行随访,比较四组患者β受体阻滞剂目标剂量达标率、左心室舒张末期内径(LVEDd)、左心室射血分数(LVEF)、6分钟步行实验及预后指标(累积无心衰再住院生存率、累积无心血管事件死亡生存率和累积无终点事件生存率)。结果B组β受体阻滞剂目标剂量达标率高于其他组,治疗后LVEDd低于其他组,LVEF高于其他组,6分钟步行实验步行距离高于其他组,差异有统计学意义(P<0.05);四组患者的12个月累积无心衰再住院生存率、无心血管事件死亡生存率及无终点事件生存率比较,差异无统计学意义(P>0.05)。结论在12个月观察期内,抗β1AR抗体阳性的扩张型心肌病患者采用富马酸比索洛尔片目标剂量达标率更高、心脏结构和心功能指标改善更明显。Objective To compare the effect of differentβreceptor blockers in the treatment of anti-β1AR antibody-positive dilated cardiomyopathy.Methods One hundred and sixty patients with anti-β1AR antibody-positive dilated cardiomyopathy(DCM)from December 2018 to February 2020 in our hospital were selected.The patients were randomly assigned to four groups of A,B,C,and D,40 in each group.The four groups were treated with standardized therapy according to the guidelines.Among the groups,the group A took carvedilol tablets,the group B took bisoprolol fumarate tablets,the group C took metoprolol tartrate tablets,and the group D took metoprolol succinatesustained-release tablets for 12 months.The four groups were followed up after 6 and 12 months of treatment.The target dose compliance rate ofβreceptor blockers,left ventricular end-diastolic diameter(LVEDd),left ventricular ejection fraction(LVEF)and 6 minute walk test as well as prognostic indexessuch as cumulative heart failure-free re-hospitalization survival,cumulative cardiovascular event-free death survival and cumulative end-free event survival were compared among the four groups.Results The target dose compliance rate ofβreceptor blockers in the group B was higherthan that of other groups.After treatment,the LVEDd value was lower,the LVEF value was higher,and the walking distance of 6-minute walk test was longer in the group B than those of other groups(P<0.05).There was no statistical significance in 12-month cumulative heart failure re-hospitalization survival,12-month cumulative cardiovascular event-free death survival,and 12-month cumulative endpoint event-free survival among the four groups(P>0.05).Conclusion During the 12-month observation period,for patients with anti-β1AR antibody-positiveDCM,treatment with bisoprolol fumarate tablets has a higher target dose compliance rate.It also improves cardiac structure and cardiac function indexesmore obviously.

关 键 词：抗β1AR抗体阳性 扩张型心肌病 Β受体阻滞剂 目标剂量达标率 心功能和心脏结构指标 预后指标 

分 类 号：R541.61[医药卫生—心血管疾病]