足量美托洛尔片治疗中重度心肌桥的临床观察  

Clinical observation of sufficient metoprolol tablet in treatment of moderate to severe myocardial bridge

作　　者：衣少伟 孔记华 赵惠贞 武宗寅[1] YI Shaowei;KONG Jihua;ZHAO Huizhen;WU Zongyin(Department of Cardiology,Jining No1.People’s Hospital,Jining,Shandong 272011,China;Department of Emergency Medicine,Jining No1.People’s Hospital,Jining,Shandong 272011,China)

机构地区：[1]山东省济宁市第一人民医院心血管内科,272011 [2]山东省济宁市第一人民医院急诊内科,272011

出　　处：《重庆医学》2022年第19期3314-3316,3321,共4页Chongqing medicine

基　　金：“十三五”国家重点研发专项支持的国家级重大研究项目(2018YFC1312404)。

摘　　要：目的分析足量美托洛尔治疗中重度心肌桥患者的疗效和安全性。方法选取2017年8月至2019年10月于该院行冠状动脉造影显示中重度心肌桥的患者41例,给予美托洛尔片口服12.5 mg,每天2次,根据患者心率、血压及耐受情况,逐步调整至患者能耐受的剂量或最大剂量(200 mg/d),使日间静息心率位于55~60次/分钟,连续随访12个月,观察患者使用美托洛尔治疗的剂量、疗效、血压、心率、左心室射血分数(LVEF)等指标。结果美托洛尔片中位使用剂量为100 mg/d,心肌桥患者心绞痛症状显著改善,治疗总有效率为95.12%。与治疗前比较,治疗后患者收缩压[(119.83±11.34)mm Hg vs.(129.46±11.73)mm Hg,P<0.001]、舒张压[(67.85±8.52)mm Hg vs.(72.22±10.95)mm Hg,P=0.047]、心率[(57.44±1.98)次/分钟vs.(76.59±7.50)次/分钟,P<0.001]均明显降低。治疗后患者LVEF明显高于治疗前[(63.15±3.13)%vs.(61.02±4.25)%,P=0.012]。结论足量应用美托洛尔能够明显改善中重度心肌桥患者临床症状。Objective To analyze the efficacy and safety of sufficient metoprolol in the treatment of the patients with moderate to severe myocardial bridge.Methods A total of 41 patients with moderate to severe myocardial bridge revealed by coronary angiography in this hospital from August 2017 to October 2019 were selected and given 12.5 mg of oral metoprolol tablet twice daily,gradually adjusted to tolerable dose or maximum dose(200 mg/d),kept the resting heart rate during the day in 55-60 times/min,and the continuous follow-up lasted for one year.The indicators such as dose,therapeutic effect,blood pressure,heart rate and LVEF were observed.Results The median dosage of metoprolol tablets was 100 mg/d,and the symptoms of angina pectoris in the patients with myocardial bridge were significantly improved.The total effective rate of treatment was 95.12%.Compared with before treatment,the systolic blood pressure[(119.83±11.34)mm Hg vs.(129.46±11.73)mm Hg,P<0.001],diastolic blood pressure[(67.85±8.52)mm Hg vs.(72.22±10.95)mm Hg,P=0.047]and heart rate[(57.44±1.98)beats/min vs.(76.59±7.50)beats/min,P<0.001]after treatment were significantly decreased.LVEF after treatment was significantly higher than that before treatment[(63.15±3.13)%vs.(61.02±4.25)%,P=0.012].Conclusion Sufficient application of metoprolol tablets can significantly improve the clinical symptoms in the patients with medium to severe myocardial bridge.

关 键 词：冠状动脉肌桥 美托洛尔 剂量 心绞痛 心脏功能 疗效 

分 类 号：R541.4[医药卫生—心血管疾病]