论文部分内容阅读
目的观察缬沙坦联用美托洛尔对扩张型心肌病(DCM)患者血浆脑钠肽(BNP)浓度变化及左室重构的影响。方法将50例DCM患者随机分成2个组,两组均给予常规治疗,包括利尿剂、硝酸酯类药和洋地黄类药等,观察组25例,给予缬沙坦80mg/d,1次/天,2周后逐渐加量至160mg,1次/d,琥珀酸美托洛尔缓释片初始剂量11.875mg,每日1次,1周后根据心功能改善情况逐渐增加剂量,每次增加11.875mg,直至总量达47.5mg/d或相对最大耐受量长期服用。对照组25例,给予缬沙坦80mg/d,1次/天,2周后逐渐加量至160mg,1次/d。两组疗程均6个月,比较两组患者血浆BNP浓度变化、左室舒张末期内径(LVEDd)、左室射血分数改善程度。结果两组患者治疗后BNP浓度变化、左室舒张末期内径(LVEDd)、左室射血分数均有明显改善(P<0.05),有统计学意义,而观察组患者较对照组患者各项指标改善更显著(P<0.05),差别有统计学意义。结论缬沙坦联用美托洛尔治疗显著改善DCM患者心室重构,降低BNP水平,优于单用缬沙坦,具有较大的临床实用意义。
Objective To observe the effect of valsartan combined with metoprolol on plasma BNP concentration and left ventricular remodeling in patients with dilated cardiomyopathy (DCM). Methods Fifty patients with DCM were randomly divided into two groups. Patients in both groups were given routine treatment, including diuretics, nitrates and digitalis. The observation group was given 25 mg valsartan 80 mg once daily , 2 weeks after the gradual increase to 160mg, 1 / d, metoprolol succinate initial release dose of 11.875mg, 1 day, 1 week after the heart function to improve the situation and gradually increase the dose, each increase of 11.875 mg, until the total amount of 47.5mg / d or the relative maximum tolerated long-term use. Control group of 25 patients, given valsartan 80mg / d, 1 / day, 2 weeks after the gradual increase to 160mg, 1 / d. The course of treatment was 6 months in both groups. The change of plasma BNP concentration, left ventricular end-diastolic dimension (LVEDd) and left ventricular ejection fraction were compared between the two groups. Results After treatment, BNP concentration, left ventricular end-diastolic dimension (LVEDd) and left ventricular ejection fraction were significantly improved in both groups (P <0.05), and there was statistical significance between the two groups Improve more significantly (P <0.05), the difference was statistically significant. Conclusion Valsartan combined with metoprolol can significantly improve ventricular remodeling and reduce BNP levels in patients with DCM, which is superior to valsartan alone. It has great clinical practical significance.