联用美托洛尔和依那普利对扩张型心肌病的疗效观察(1)
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【摘要】 目的 观察联用美托洛尔和依那普利对扩张型心肌病的临床疗效及对远期预后的影响。方法 100例扩张型心肌病均经超声心动图及X线心脏三位片确诊,按就诊顺序随机分为A、B 两组,A 组50 例给美托洛尔25～75 mg/ d,依那普利2.5~20 mg/d,B组50例服同等剂量安慰剂,两组基础治疗类同。定期来门诊随访,长期坚持服药1～4年,平均服药时间为494 d,随访满1年后均复查超声心动图,判定疗效的终点事件为病死率及临床心功能状况。结果 联用美托洛尔和依那普利使扩张型心肌病患者治疗前后6 min内步行距离、左室射血分数、左室舒张末期内径、左室收缩末期内径的变化比较差异均有统计学意义(P<0.05),治疗组心功能改善显效率(54%)及总有效率(92%)明显优于对照组(18%)、(62%)(P<0.01),差异有统计学意义。结论 在扩张型心肌病患者长期坚持联用美托洛尔和依那普利可使心功能改善,生活质量提高,改善预后。
【关键词】 扩张型心肌病,充血性;美托洛尔,依那普利
The clinical efficacy of metoprolol with enalapril for treatment of dilated cardiomyopathy
WU Rong-hui.Departm ent of Cardiology,The State Farms Hospital of Maoming, Guangdong 525200, China
【Abstract】 Objective To evaluate the clinical therapeutic efficacy and safety of metoprolol with enalapril for treatmentof dilated cardiomyopathy. Methods One hundred patients with idiopathic dilated cardiomyopathy were randomized to take small dose of metoprolol (25~75 mg per day, n=50) with enalapril (2.5 mg~20 mg per day,n=50) and to placebo (n=50) on the basis of conventional treatment. The mean of follow up periods was 494 days. The efficacy of metoprolol was assessed by means of echocardiography and clinical symptoms. Primary endpoint was mortality rate during treatment. Results Pretherapy of walking distance within sixminutes, left ejection fraction, left ventricular end-diastolic internal diameter, left ventricular endsystolic in-ternal diameter compared to latter, there is statistical difference (P<0.05).The heart function imp roved obvious efficiency(54%) and general efficiency(92%) in treatment group were better than those in control group(18%),(62%),there was statistical difference (P<0.01).Conclusion Longterm addition of metoprolol to standard therapy may profoundly improve cardiac function and prognosis and preventclinical deterioration in patients with idiopathic dilated cardiomyopathy when compared with patients without metoprolol treatment.
【Key words】 Dilated cardiomyopathy; Congestive; Metoprolol; Enalapril ......
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