2018 年第 4 期 第 13 卷

琥珀酸美托洛尔治疗射血分数保留的心力衰竭患者的有效性评估

Effect of metoprolol succinate on heart failure with preserved ejection fraction

作者：韩磊森

英文作者：

单位：710043西安，陕西省第四人民医院心血管内科

英文单位：

关键词：心力衰竭；琥珀酸美托洛尔

英文关键词：

• 摘要：

• 目的    评估琥珀酸美托洛尔治疗射血分数保留的心力衰竭患者的有效性。方法    选取2013年 5月至2017年4月于陕西省第四人民医院诊断为射血分数保留的心力衰竭患者104例作为研究对象。按照随机数字表法分为A、B组，每组52例。B组患者给予琥珀酸美托洛尔口服治疗，A组给予与 B组同等剂量安慰剂口服治疗。主要观察指标为治疗24周后各组纽约心脏病协会（NYHA）分级改善情况；次要指标包括运动能力、超声心动图测量的左心室壁厚和质量、N末端脑钠肽前体、Ⅰ型前胶原羧基端肽(PICP)及生命质量评分的变化情况。结果    治疗后，B组NYHA心功能分级改善的患者比例明显高于A组［32.7%（17/52）比11.5%（6/52）］（P<0.05）；B组患者的运动能力、左心室质量、左心室舒张末期容积、左心室收缩末期容积及PICP改善情况较A组更为明显，差异均有统计学意义（均P<0.05）。 B组患者的躯体功能、情感健康、社会功能及总体健康评分改善情况较A组更为明显，差异均有统计学意义（均P<0.05）。结论    琥珀酸美托洛尔对射血分数保留的心力衰竭患者具有良好的临床效果。

• Objective    To assess the effect of metoprolol succinate on heart failure with preserved ejection fraction. Methods    Totally 104 patients diagnosed of heart failure with preserved ejection fraction from May 2013 to April 2017 in the Fourth People′s Hospital of Shaanxi were randomly divided into group A and B, with 52 patients in each group. The group B took metoprolol succinate and the group A took equivalent placebo. Heart function was assessed by the New York Heart Association(NYHA) classification 24 weeks after treatment. Exercise capacity, echocardiogram parameters, levels of N-terminal pro-brain natriuretic peptide and procollagen type Ⅰ carboxy-terminal extension peptide(PICP) and scores of life quality were analyzed. Results   After treatment, improvement ratio of the NYHA classification in group B was significantly higher than that in group A［32.7%（17/52） vs 11.5%（6/52）］(P<0.05). Changes of exercise capacity, left ventricular mass, left ventricular end-diastolic volume, left ventricular end-systolic volume and PICP level in group B were more significant than those in group A(P<0.05). Improvements of physical function, emotional health, society function and general health scores in group B were more significant than those in group A(P<0.05). Conclusion    Metoprolol succinate shows good therapeutic effect on heart failure with preserved ejection fraction.