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目的观察美托洛尔、卡托普利联合治疗慢性心功能衰竭的疗效并探讨其临床应用价值。方法选择120例慢性心功能衰竭(CHF)患者给予传统利尿、扩血管、强心等常规治疗,使心功能稳定后随机分为三组:A组(卡托普利组),给予卡托普利6.25 mg,每日3次,如无特别不适,每周渐加倍量至目标剂量50 mg,每日3次,维持治疗;B组(美托洛尔组)初始剂量给予美托洛尔6.25 mg,每日2次,1周后上调剂量至12.5 mg,每日2次,如无特别不适,后每周渐加倍量至目标剂量50 mg,每日2次,维持治疗。C组(卡托普利+美托洛尔组),初始给予卡托普利6.25 mg,每日3次,1周后给予美托洛尔6.25 mg,每日2次,后每周渐加倍量至上述目标剂量,维持治疗,分别于3个月至2年进行随访。结果总有效率A组62.5%,B组60%,C组87.5%。C组与A、B两组相比,差异有统计学意义(P<0.05),且C组再住院率、死亡率较A、B两组明显下降(P<0.05)。结论慢性心力衰竭患者病情稳定后,联用ACEI制剂和β-受体阻滞剂,可明显改善患者心功能,改善生活质量,提高运动耐量,降低再住院率和死亡率。
Objective To observe the curative effect of metoprolol and captopril in treating chronic heart failure and discuss its clinical value. Methods A total of 120 patients with chronic heart failure (CHF) were given conventional diuretic, vasodilator and cardiac therapy. The heart function was stabilized and then divided into three groups randomly: group A (captopril group) Lee 6.25 mg, 3 times a day, without any discomfort, weekly doubling to the target dose of 50 mg, 3 times a day to maintain treatment; B group (metoprolol group) initial dose of metoprolol 6.25 mg twice daily. After 1 week, the dose should be increased to 12.5 mg twice daily. If there is no special discomfort, the dosage should be doubled every week to the target dose of 50 mg twice daily to maintain the treatment. In group C (captopril + metoprolol group), captopril was initially given 6.25 mg three times a day, metoprolol 6.25 mg twice a day after 1 week, then doubled weekly The amount of the target dose to maintain the treatment, were followed up for 3 months to 2 years. Results The total effective rate was 62.5% in group A, 60% in group B and 87.5% in group C. There was significant difference between group C and groups A and B (P <0.05), and the rehospitalization rate and mortality of group C were significantly lower than those of group A and B (P <0.05). Conclusion In patients with chronic heart failure, ACEI and β-blockers can improve cardiac function, improve quality of life, increase exercise tolerance and reduce hospitalization and death rate after treatment.