摘要
目的随访观察美托洛尔治疗慢性心力衰竭(CHF)患者的5年远期效果。方法 102例慢性心力衰竭患者,随机分为治疗组与对照组,各51例。对照组给予口服血管紧张素转换酶抑制剂(ACEI)+利尿药为主要治疗药物,治疗组在对照组基础上加用美托洛尔治疗。观察两组患者5年生存率、死亡率、再住院率、心功能指标水平变化情况。结果 5年观察期间,治疗组与对照组各失访2例。5年观察期间,治疗组死亡4例,对照组死亡11例,均因心力衰竭恶化死亡,无非心血管事件死亡者。治疗组5年生存率91.8%(45/49)明显高于对照组的77.6%(38/49),病死率8.2%(4/49)明显低于对照组的22.4%(11/49),差异具有统计学意义(χ~2=3.86,P<0.05)。5年观察期间,因心力衰竭加重再次住院患者治疗组有8例(16.3%),明显少于对照组的17例(34.7%),差异具有统计学意义(χ~2=4.35,P<0.05)。将两组失访患者排除。治疗前,两组左室射血分数(LVEF)水平比较差异无统计学(P>0.05);治疗5年后,两组LVEF水平均较治疗前明显改善,且治疗组改善优于对照组,差异均具有统计学意义(P<0.05)。结论美托洛尔可以显著降低慢性心力衰竭患者的病死率,可持续改善远期预后,应终身服药。
Objective To observe the 5-year long-term effet of metoprolol in the treatment of chronic heart failure（CHF）. Methods A total of 102 chronic heart failure patients were randomly divided into treatment group and control group, with 51 cases in each group. The control group received oral angiotensin converting enzyme inhibitor（ACEI） and diuretic drug as the main therapeutic drug, and the treatment group received metoprolol on the basis of the control group. Observation were made on 5-year survival rate, mortality, rehospitalization rate, change of heart function index between the two groups. Results During the 5-year observation period, there were 2 cases lost to follow-up in the treatment group and the control group. During the 5-year observation period, there were 4 deaths in the treatment group and 11 deaths in the control group, all of which died of heart failure, and no case died of non-cardiovascular events. The treatment had obviously higher 5-year survival rate as 91.8%（45/49） than 77.6%（38/49） in the control group, and obviously lower mortality rate as 8.2%（4/49） than 22.4%（11/49） in the control group. Their difference was statistically significant（χ~2=3.86, P〈0.05）. During the 5-year observation period, 8 cases（16.3%） in the treatment group were re-hospitalized due to heart failure, which was significantly less than 17 cases（34.7%） in the control group, and the difference was statistically significant（χ^2=4.35, P〈0.05）. Cases lost to follow-up in two groups were excluded. Before treatment, There was no statistical difference in left ventricular ejection fraction（LVEF） levels between the two groups（P〉0.05）. After 5 year of treatment, both groups had obviously improved LVEF levels than before treatment, and the treatment group had better improvement than the control group. Their difference was statistically significant（P〈0.05）. Conclusion Metoprolol can obviously lower the mortality rate of patients with chronic heart failure, and continue to improve long-term prognosis. It should be long-term medication.
作者
王荣辉
曾广权
谢统辉
苏伟兴
吴金亮
谭其焜
WANG Rong-hui;ZENG Guang quan;XIE Tong-hui(Guangdoag Zhongshan Western District Community Health Service Center, Zhongshan 528400, Chin)
出处
《中国实用医药》
2018年第15期8-10,共3页
China Practical Medicine
关键词
美托洛尔
慢性心力衰竭
远期随访
Metoprolol
Chronic heart failure
Long-term follow-up
