CAJ | 학술논문

目的：探讨琥珀酸美托洛尔缓释片对慢性心力衰竭（ CHF）患者心功能、6分钟步行试验（6MWT）距离及血浆脑钠肽（ BNP）水平的影响。方法选取2012年3月—2014年8月南方医科大学第五附属医院心内科收治的CHF患者98例，按随机数字表法分为试验组和对照组，各49例。对照组患者给予利尿剂、血管扩张剂、强心类药物等常规药物治疗；试验组患者在常规药物治疗基础上加服琥珀酸美托洛尔缓释片。治疗3个月后评价临床疗效，比较两组患者治疗前和治疗3个月后心功能指标〔左心室舒张末期内径（ LVEDD）、左心室收缩末期内径（ LVESD）及左心室射血分数（LVEF）〕、6MWT距离及血浆BNP水平，并观察治疗期间不良反应发生情况。结果治疗前两组患者LVEDD、LVESD及LVEF比较，差异无统计学意义（ P>0.05）；治疗后试验组患者LVEDD和LVESD小于对照组， LVEF高于对照组（P<0.05）。治疗前两组患者6MWT距离及血浆BNP水平比较，差异无统计学意义（P>0.05）；治疗后试验组患者6MWT距离长于对照组，血浆BNP水平低于对照组（P<0.05）。试验组患者临床疗效优于对照组（u=4.021，P<0.05）。治疗期间试验组患者6例出现轻微不良反应。结论琥珀酸美托洛尔缓释片能有效提高CHF患者临床疗效，改善患者心功能、增加6MWT距离、降低血浆BNP水平，且安全性较高。
목적：탐토호박산미탁락이완석편대만성심력쇠갈（ CHF）환자심공능、6분종보행시험（6MWT）거리급혈장뇌납태（ BNP）수평적영향。방법선취2012년3월—2014년8월남방의과대학제오부속의원심내과수치적CHF환자98례，안수궤수자표법분위시험조화대조조，각49례。대조조환자급여이뇨제、혈관확장제、강심류약물등상규약물치료；시험조환자재상규약물치료기출상가복호박산미탁락이완석편。치료3개월후평개림상료효，비교량조환자치료전화치료3개월후심공능지표〔좌심실서장말기내경（ LVEDD）、좌심실수축말기내경（ LVESD）급좌심실사혈분수（LVEF）〕、6MWT거리급혈장BNP수평，병관찰치료기간불량반응발생정황。결과치료전량조환자LVEDD、LVESD급LVEF비교，차이무통계학의의（ P>0.05）；치료후시험조환자LVEDD화LVESD소우대조조， LVEF고우대조조（P<0.05）。치료전량조환자6MWT거리급혈장BNP수평비교，차이무통계학의의（P>0.05）；치료후시험조환자6MWT거리장우대조조，혈장BNP수평저우대조조（P<0.05）。시험조환자림상료효우우대조조（u=4.021，P<0.05）。치료기간시험조환자6례출현경미불량반응。결론호박산미탁락이완석편능유효제고CHF환자림상료효，개선환자심공능、증가6MWT거리、강저혈장BNP수평，차안전성교고。
Objective To investigate the impact of metoprolol succinate sustained - release tablets on cardiac function,6-minute walking distance and plasma BNP level of chronic heart failure patients. Methods From March 2012 to August 2014,a total of 98 chronic heart failure patients were selected in the Department of Cardiology,the Fifth Affiliated Hospital of Southern Medical University,and they were divided into control group and test group according to random number table,each of 49 cases. Patients of control group received routine drug treatment,including diuretic,vasoliator,cardiotonic drugs and so on,while patients of test group received extra metoprolol succinate sustained-release tablets based on routine drug treatment. After 3 months of treatment,clinical effect was evaluated;cardiac function index( including LVEDD,LVESD and LVEF),6-minute walking distance and plasma BNP level before and after 3 months of treatment were compared between the two groups,and incidence of adverse reactions during treatment was observed. Results No statistically significant differences of LVEDD,LVESD or LVEF was found between the two groups before treatment ( P >0. 05 );after treatment, LVEDD and LVESD of test group were statistically significantly shorter than those control group,while LVEF of test group was statistically significantly higher than that of control group(P<0. 05). No statistically significant differences of 6-minute walking distance or plasma BNP level was found between the two groups before treatment ( P <0. 05 );after treatment,6 - minute walking distance of test group was statistically significantly longer than that of control group,while plasma BNP level of test group was statistically significantly lower than that of control group(P<0. 05). The clinical effect of test group was statistically significantly better than that of control group(u=4. 021,P<0. 05). During treatment,6 cases of test group occurred mild adverse reactions. Conclusion Metoprolol succinate sustained-release tablets can effectively improve the clinical effect and cardiac function of chronic heart failure patients,increase the 6-minute walking distance and reduce the plasma BNP level,and is safe.