摘要
目的观察并比较美托洛尔和依那普利对冠心病充血性心力衰竭并室性心律失常的疗效。方法2004-04～2005-04选择我院心内科门诊或病房的冠心病充血性心力衰竭(NYHAⅢ-Ⅳ)伴有室性心律失常患者42例,在强心、利尿、硝酸酯治疗的基础上,随机给予美托洛尔(12.5～100mg/d)或依那普利(2.5～20mg/d),治疗16周。分别于治疗前、后进行24h动态心电图监测与临床心功能评估。结果治疗后24h室性心律失常总检出率美托洛尔组下降了41.1%,依那普利组下降了17.1%。二者差异显著(P<0.01)。复杂室性心律失常及室性心动过速检出率美托洛尔组分别下降了64.4%、66.7%,依那普利组下降了15.3%、12.5%,两组差异显著(均P<0.01)。两组患者心功能均获明显提高,但组间无显著性差异(P>0.05)。结论美托洛尔和依那普利均较好改善冠心病心衰患者心功能,美托洛尔同时具有干预高级别室性心律失常发生的特殊效应。笔者认为在冠心病心力衰竭治疗中先于血管紧张素转换酶抑制剂使用更好。
Objective To observe and compare the therapeutic effects of metoprolol and enalapril on ventricular arrhythmia （VA）in patients with congestive heart failure （CHF） of coronary heart disease Methods Forty-two patients of ventricular arrhythmia with congestive heart failure of coronary heart disease （NYHAllI-IV）under conventional therapy were random divided into two groups： given metoprolol （12.5-100mg/d）or enalapril （2.5-20mg/d）for 16 weeks. Before and after treatment VA was recorded by 24-hour ambulatory electrocardiographic monitoring and cardiac function was estimated by clinical symptoms and signs.Results After treatment the total incidence of VA in24h reduced by 41.4% and17.1% （P〈0.01）in the metoprolol and enalapril groups,respectively.The incidences of complex VA and ventricular tachycardia were reduced by 64.4% and 66.7%,respectively in the metoprolol group,and only reduced by 15.3%and 12.5%,respectively in the enalapril group.Between two groups there was significant difference （all, P〈0.01）.The improvement of cardiac function was similar in both groups.Conclusion Both metoprolol and enalapril could good improve cardiac function,but metoprolol could also reduce the incidence of high class VA patiets with CHF of coronary heart disease.
出处
《实用医药杂志》
2006年第6期650-652,共3页
Practical Journal of Medicine & Pharmacy
