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美托洛尔和氯沙坦联合治疗慢性充血性心力衰竭的疗效(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2005年第5期
页码:
476-478
栏目:
临床研究
出版日期:
2005-10-05

文章信息/Info

Title:
Therapeutic effect of metaprolol combined with losartan on chronic congestive heart failure
作者:
宝云龙; 谷晓颖
通辽市医院心内科，内蒙古 通辽 028000
Author(s):
BAO Yunlong;  GU Xiaoying
Department of Cardiology, Hospital of Tong liao, Tongliao， Inner Mongolia 028000, China
关键词:
心力衰竭; 充血性; 美托洛尔; 氯沙坦; 超声心动描记术
Keywords:
heart failure; congestive;  metaprolol;  losartan;  echocardiography
分类号:
R541.61
DOI:
-
文献标识码:
A
摘要:
目的 观察美托洛尔联合氯沙坦治疗慢性充血性心力衰竭（CHF）的疗效。方法 将76例缺血性或非缺血性心脏病伴轻中度心力衰竭的患者随机分为2组，38例应用美托洛尔联合氯沙坦治疗（联合治疗组），38例单用氯沙坦治疗（氯沙坦组）。在CHF标准用药的基础上，美托洛尔和氯沙坦均由小剂量开始，逐渐递增到目标量。采用超声心动图评价左室功能和容积，一年内检查3次。结果 治疗后两组的左室射血分数（LVEF）均有增加，左室收缩末期容积（LVESV）和左室舒张末期容积（LVEDV）均减少，联合治疗组与氯沙坦组比较差异有显著性（P<0.05），联合治疗组有32例耐受目标量，其常见的不良反应为头晕、轻咳，与氯沙坦组比较差异无显著性。结论 美托洛尔联合氯沙坦治疗常规用药治疗基础上的轻、中度CHF安全有效，可显著改善心功能。
Abstract:
AIM To investigate the efficacy and safety of metaprolol combined with losartan in the treatment of chronic congestive heart failure (CHF). METHODS The study involved 76 patients （82% with coronary artery disease， CAD）. with mild and moderate CHF. The patients were randomly divided into two groups: combination group receiving metaprolol and losartan(n=38), single group given losartan only(n=38). The adminstration of durgs started at low dose and increased gradually to target dose in addition to routine therapy. Echocardiography was performed three times with in 12 months on all patients to evaluate left ventricular function and volume. RESULTS Left ventricular ejection fraction (LVEF) increased in two groups, while left ventricular end diastolic volume (LVEDV ) and left ventricular endsystolic volume (LVESV) decreased in two groups. The changes were more significant in the combination group than in the single group (P<0.05). There were 32 patients (84%) in the combination group were tolerant to target dose. Similiar side effects were found in both groups with dizziness as the main side effect. CONCLUSION The combination of metaprolol and losartan is effective and safe in the treatment of mild and moderate CHF, especially in the improvement of left ventricle function.

参考文献/References

［1］ 臧益民，臧伟进，王晓明. 心力衰竭的病理生理机制及治疗概述［J］. 心脏杂志，2002，14（5）：417-419.

［2］ Fukuzawa J, Booz GW, Hunt RA, et al. Cardiotrophin1 increases angiotensinogen mRNA in rat cardiac myocyte through STAT3an autocrine loop for hypertrophy ［J］. Hypertension, 2000, 35:1191-1196.

［3］ Hunt SA, Baker DW, Chin MH, et al. ACC/AHA guidelines for the evalaution and management of chronic heart failare in the adult: executive summary. A report of the ACC/AHA task force on practice guidelines ［J］. J Am Coll Cardiol, 2001, 38:2101-2114.

［4］ 中华医学会心血管病分会中华心血管病杂志编辑委员会.慢性收缩性心力衰竭治疗建议［J］.中华心血管病杂志，2001，30：7-23.

［5］ Wikstrason A, Wagstein F et al. Dose of metaprolol CR/XL and clinical outcomes in patients with heart failure analysis of the experience in metaprolol CR/XL randomized intervention trial in chronic heart failure(MERIT-HF)［J］. J Am Coll Cardiol, 2003,40:491-498.

［6］ 杨彬，成蓓，刘承云,等. 氯沙坦在损伤血管重构中的作用及其机制的探讨［J］. 心脏杂志，2004，16（1）：23-28.

［7］ CIBIS Investigors and committees. The cardiac insufficiency bisoprolol study Ⅱ(CIBIS)a randomised trail ［J］. Lancet, 1999,353(9146):9-13.

备注/Memo

备注/Memo:
收稿日期：2004-09-30.
更新日期/Last Update: 2010-01-05