美托洛尔对慢性心力衰竭患者心肌重构和血清炎性因子的影响  

Effects of metoprolol on myocardial remodeling and serum inflammatory factors levels in patients with chronic heart failure

作　　者：温嘉平 杜婉微 张小妹 WEN Jiaping;DU Wanwei;ZHANG Xiaomei(Department of Pharmacy,Foshan Gaoming District People′s Hospital,Guangdong Province,Foshan 528500,China)

机构地区：[1]广东省佛山市高明区人民医院药学部,528500

出　　处：《临床合理用药》2025年第8期4-7,共4页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的 观察美托洛尔对慢性心力衰竭患者心肌重构和血清炎性因子的影响。方法 选取2022年1月—2023年12月于佛山市高明区人民医院接受诊治的慢性心力衰竭患者106例,采取随机数字表法分为观察组和对照组,每组53例。对照组接受常规治疗,观察组在常规治疗的基础上接受美托洛尔治疗,2组均治疗6个月。比较2组临床疗效,治疗前后心肌重构指标[左室收缩末期内径(LVESD)、左室舒张末期内径(LVEDD)、左室射血分数(LVEF)]、血清炎性因子[肿瘤坏死因子-α(TNF-α)、白介素-1β(IL-1β)和白介素-6(IL-6)]水平、6 min步行距离、心率及不良反应。结果 观察组治疗总有效率为96.23%,高于对照组的83.02%(χ^(2)=4.970,P=0.026)。治疗6个月后,2组LVESD、LVEDD小于治疗前,TNF-α、IL-6、IL-1β水平低于治疗前,LVEF高于治疗前,且观察组小/低/高于对照组(P<0.05或P<0.01);2组6 min步行距离长于治疗前,心率低于治疗前,且观察组长/低于对照组(P<0.01)。观察组与对照组不良反应总发生率比较差异无统计学意义(5.66%vs. 9.43%,χ^(2)=0.541,P=0.462)。结论 美托洛尔在慢性心力衰竭治疗中应用效果显著,可改善患者心功能,减轻炎性反应,且具有较高安全性。Objective To observe the effect of metoprolol on myocardial remodeling and serum inflammatory factors levels in patients with chronic heart failure.Methods One hundred and six patients with chronic heart failure who received treatment in Foshan Gaoming District People′s Hospital from January 2022 to December 2023 were selected,and they were divided into the observation group and the control group by the method of randomized numerical table,with 53 cases in each group.The control group received conventional treatment,and the observation group received metoprolol treatment on the basis of conventional treatment,and both groups were treated for 6 months.The clinical efficacy,and the myocardial remodeling indexes(LVESD,LVEDD,LVEF),serum inflammatory factors(TNF-α,IL-1βand IL-6)levels,6 minutes walk distances,heart rate before and after treatment,and adverse reactions of the two groups were compared.Results The total effective rate of treatment in the observation group was 96.23%,which was higher than 83.02%in the control group(χ^(2)=4.970,P=0.026).After 6 months of treatment,LVESD,LVEDD and the levels of TNF-α,IL-6,IL-1βin the two groups were less or lower than those before treatment,and LVEF was higher than that before treatment,and the observation group was less/lower/higher than that of the control group(P<0.05 or P<0.01).The 6 minutes walk distance in both groups were longer than before treatment,and the heart rate in both groups were lower than before treatment,and the observation group was longer/lower than the control group(P<0.01).There was no statistically significant difference in the total incidence of adverse reactions between the observation group and control group(5.66%vs.9.43%,χ^(2)=0.541,P=0.462).Conclusion The application of metoprolol in the treatment of chronic heart failure has significant effect,which can improve cardiac function,reduce inflammatory response,and has high safety.

关 键 词：慢性心力衰竭 Β受体阻滞剂 美托洛尔 心肌重构 血清炎性因子 不良反应 

分 类 号：R54[医药卫生—心血管疾病]