CAJ | 학술논문

目的：比较严格管理静息心率与常规治疗对心力衰竭（心衰）患者心功能和生活质量的影响。方法慢性心衰住院患者共93例，随机分为试验组（严格控制心率组48例）和对照组（常规治疗组45例），所有病例均予以心衰指南导向性治疗[1]。试验组通过调整美托洛尔缓释片剂量严格控制静息心率达目标心率。随访1年，比较两组患者的纽约心功能分级（NYHA）、左室射血分数（LVEF）、左室舒张末内径（LVEDD）、左室收缩末内径（LVESD）、血浆NT-proBNP、6分钟步行试验（6MWT）、明尼苏达心衰生活质量评分的差异。结果试验组经过严格控制心率后在LVEF、LVEDD、NYHA、血浆NT-proBNP、6MWT指标与对照组比较，均有明显改善，差异具有显著统计学意义（P＜0.05）。结论通过对慢性心衰患者静息心率的严格控制，可改善其心功能情况及提高患者的生活质量。
목적：비교엄격관리정식심솔여상규치료대심력쇠갈（심쇠）환자심공능화생활질량적영향。방법만성심쇠주원환자공93례，수궤분위시험조（엄격공제심솔조48례）화대조조（상규치료조45례），소유병례균여이심쇠지남도향성치료[1]。시험조통과조정미탁락이완석편제량엄격공제정식심솔체목표심솔。수방1년，비교량조환자적뉴약심공능분급（NYHA）、좌실사혈분수（LVEF）、좌실서장말내경（LVEDD）、좌실수축말내경（LVESD）、혈장NT-proBNP、6분종보행시험（6MWT）、명니소체심쇠생활질량평분적차이。결과시험조경과엄격공제심솔후재LVEF、LVEDD、NYHA、혈장NT-proBNP、6MWT지표여대조조비교，균유명현개선，차이구유현저통계학의의（P＜0.05）。결론통과대만성심쇠환자정식심솔적엄격공제，가개선기심공능정황급제고환자적생활질량。
Objective To compare the influences of strict management of resting heart rate (HR) and routine treatment on heart function and quality of life in patients with chronic heart failure (CHF). Methods CHF patients (n=93) were randomly divided into test group (strict control of HR, n=48) and control group (routine treatment, n=45), and all given heart failure guideline directed therapy. The test group was given strict control of resting HR for target HR through adjusting the dose of metoprolol sustained-release tablets. After follow-up for 1 y, New York Heart Function Assessment (NYHA), left ventricular ejection fraction (LVEF), left ventricular end-diastolic inner diameter (LVEDd), left ventricular end systolic diameter (LVESd), plasma NT-proBNP, 6-minute walk test (6MWT) and scores of Minnesota Table of Quality of Life were compared between 2 groups. Results The difference in LVEF,LVEDD,NYHA, plasma NT-proBNP and 6MWT had statistical significance compared between 2 groups (P<0.05) after strict HR control. Conclusion Strict management of resting HR can improve heart function and quality of life in CHF patients.