【摘要】 目的探讨不同剂量美托洛尔对无症状左心室收缩功能障碍患者左心室重构的影响。方法选取成都市青白江区人民医院自2015年1月至2016年1月门诊及住院无症状左心室收缩功能障碍患者,符合入选及排除标准共308例,按随机数字表法分为对照组、低剂量组、高剂量组。对照组不给予美托洛尔,低剂量组给予美托洛尔47.5 mg/d,高剂量组给予美托洛尔190 mg/d或达最大耐受剂量治疗。所有患者随访12个月,比较组间患者超声心动图参数,评价患者心室重构情况。结果经过12个月随访,低剂量组和高剂量组左心室舒张末期容积指数(left ventricular end-diastolic volume index,LVEDVI)与对照组比较,差异无统计学意义(P>0.05);左心室收缩末期容积指数(left ventricular end-systolic volume index,LVESVI)、左心室质量指数(leftventricular mass index,LVMI)降低,射血分数(ejection fraction,EF)增高,差异有统计学意义(P<0.05)。高剂量组LVEDVI与低剂量组比较,差异无统计学意义(P>0.05);然而LVMI、LVEDSI明显降低,EF增高,差异有统计学意义(P<0.05)。结论美托洛尔能逆转无症状左心室功能障碍患者心室重构,其作用具有剂量依赖性。更多还原

【Abstract】 Objectives To investigate the effect of different dosages of metoprolol on left ventricular remodeling in patients with asymptomatic left ventricular systolic dysfunction. Methods According to inclusion and exclusion criteria,308 patients(outpatient or hospitalized in Qingbaijiang District People’s Hospital of Chengdu) with asymptomatic left ventricular systolic dysfunction were selected from January 2015 to January 2016. All the patients were divided into control group, low dosage group and high dosage group by random number table method. Patients in control group were not given metoprolol while patients in low dosage group were given metoprolol 47.5 mg/d and patients in high dosage group were given 190 mg/d or up to the optimal tolerated dosage. All the patients were followed up for 12 months to compare echocardiographic parameters to evaluate the situation of left ventricular remodeling. Results After 12 months follow-up, there were no significant differences of left ventricular end-diastolic volume index( LVEDVI) in low dosage group or high dosage group compared with control group(P>0.05); while left ventricular end-systolic volume index(LVESVI), left ventricular mass index(LVMI) significantly decreased and ejection fraction( EF) significantly increased in low dosage group or high dosage group compare with control group(P<0.05). In addition, there was no significant difference in LVEDVI between high dosage group and low dosage group(P>0.05),but LVMI and LVESVI significantly decreased while EF significantly increased(P<0.05) when high dosage group compared with low dosage groop. Conclusions Metoprolol can reverse ventricular remodeling in patients with asymptomatic left ventricular dysfunction,and its effect is dosage-dependent.更多还原