不同β-受体阻滞剂治疗心室收缩不同步特发性扩张型心肌病的临床疗效

摘要

目的：观察不同β-受体阻滞剂治疗心室收缩不同步特发性扩张型心肌病（IDC）的临床疗效。方法收集2009年1月至2011年6月，该院收治的65例 IDC 患者，分为卡维地洛组（n＝33例）和美托洛尔组（n＝32例）。分别于用药前和用药后6个月多普勒超声心动图检测患者心功能，ELISA 检测血浆中 N 末端原脑利钠肽（NT-pro-BNP）表达水平，并做长期随访。结果卡维地洛组较美托洛尔组左室收缩末内径降低和左室射血分数升高更明显，在改善心室收缩不同步状况和促进生存率方面卡维地洛组优于美托洛尔组。但是，两组血浆 NT-pro-BNP 在用药前后比较，差异无统计学意义（P ＞0．05）。结论卡维地洛可以有效改善心室收缩不同步 IDC 患者的心功能，提高患者生存率。%Objective To evaluate the impact of carvedilol and metoprolol on left ventricular (LV)dyssynchrony in idiopathic dilated cardiomyopathy(IDC).Methods In this study,we randomly assigned 65 IDC patients from January 2009 to June 2011 to re-ceive carvedilol or metoprolol succinate.All patieats were divided in to carvedilol group(n=33)and metoprolol group(n=32)Echo-cardiographic measurements and N-terminal pro-brain natriuretic peptide levels were obtained at baseline and 6 month after thera-py.Then long-term follow up the survival rate of patients were observed.Results In carvedilol group,reduction in LVEDS and in-crease in LVEF was higher compared to metoprolol group.Also improvement in LV dyssynchrony achieved and survival rate with carvedilol was higher than metoprolol.However,Improvements in LV mechanical dyssynchrony was similar in two groups.Im-provements in LV mechanical dyssynchrony achived with both drugs were accompanied by reduction in NT-pro-BNP levels in both carvedilol and metoprolol groups(P >0.05).Conclusion Carvedilol is an effective drug improves the intraventricular dyssynchro-nyfor for IDC patients with left ventricular dyssynchrony,and could increasea the survival rate.