美托洛尔与比索洛尔治疗舒张性心力衰竭的疗效和安全性比较
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篇名: 美托洛尔与比索洛尔治疗舒张性心力衰竭的疗效和安全性比较
TITLE:
摘要: 目的:比较美托洛尔与比索洛尔治疗舒张性心力衰竭的疗效和安全性。方法:150例舒张性心力衰竭患者随机分为A组(75例)和B组(75例)。两组患者均给予阿司匹林、血管紧张素转换酶抑制剂、血管紧张素受体拮抗药、钙拮抗药、利尿药及强心药等常规治疗。在此基础上,A组患者给予酒石酸美托洛尔片初始剂量6.25 mg,口服,每日2次,根据病情改善情况及耐受性酌情加量至100~200 mg,口服,每日2次;B组患者给予富马酸比索洛尔片初始剂量1.25 mg,口服,每日1次,根据病情改善情况及耐受性酌情加量至10 mg,口服,每日1次。两组疗程均为12周。观察两组患者的临床疗效,治疗前后的左心室收缩末期内径(LVESD)、左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、心肌性能(LVTei)指数、脑钠肽(BNP)、白细胞介素-1(IL-1)、IL-6、肿瘤坏死因子-α(TNF-α)及不良反应发生情况。结果:B组患者总有效率显著高于A组,不良反应发生率显著低于A组,差异均有统计学意义(P<0.05)。治疗前,两组患者LVESD、LVEF、 LVEDD、LVTei指数和BNP 、IL-1、IL-6、TNF-α水平比较,差异均无统计学意义(P>0.05)。治疗后,两组患者LVESD、LVEDD、LVTei指数和BNP 、IL-1、IL-6、TNF-α水平均显著低于同组治疗前,且B组低于A组,LVEF显著高于同组治疗前,且B组高于A组,差异均有统计学意义(P<0.05)。结论:在常规治疗的基础上,比索洛尔治疗舒张性心力衰竭的疗效、缓解临床症状、改善心脏功能、安全性均显著优于美托洛尔。
ABSTRACT: OBJECTIVE: To compare the efficacy and safety of metoprolol and bisoprolol in the treatment of diastolic heart failure. METHODS: 150 patients with diastolic heart failure were randomly divided into group A(75 cases) and group B(75 cases). All patients received aspirin, angiotensin-converting enzyme inhibitors, angiotensin receptor antagonists, calcium antagonists, diuretic and cardiac drugs and other conventional treatment; based on it, group A received Metoprolol tartrate tablet with initial dose of 6.25 mg, orally, twice a day, then increased to 100-200 mg based on improvement and tolerability; group B received 1.25 mg Metoprolol tartrate tablet, orally, once a day, then increased to 10 mg based on improvement and tolerability. The treatment course for 2 groups was 12 weeks. Clinical efficacy, and left ventricular end systolic diameter (LVESD), left ventricular ejection fraction (LVEF) and left ventricular end-diastolic diameter (LVEDD), myocardial performance index (LVTei index), brain natriuretic peptide (BNP), interleukin (IL)-1,IL-6, tumor necrosis factor (TNF)-α before and after treatment, and incidence of adverse reactions in 2 groups were observed. RESULTS: The efficacy in group B was significantly higher than group A, incidence of adverse reactions were significantly lower than group A, the differences were statistically significant (P<0.05). Before treatment, there were no significant differences in the LVESD, LVEF, LVEDD, LVTei index, BNP, IL-1, IL-6 and TNF-α in 2 groups (P>0.05). After treatment, LVESD,LVEDD, LVTei index, BNP, IL-1, IL-6 and TNF-α in 2 groups were significantly lower than before, and group B was lower than group A, LVEF was significantly higher than before, and group B was higher than group A, the differences were statistically significant(P<0.05). CONCLUSIONS: Based on the conventional treatment, bisoprolol is significantly superior to metoprolol in terms of efficacy, relieving clinical symptoms and improving cardiac functions in the treatment of diastolic heart failure, with better safety.
期刊: 2016年第27卷第18期
作者: 吴雷,耿国英,赵明虎
AUTHORS: WU Lei,GENG Guoying,ZHAO Minghu
关键字: 美托洛尔;比索洛尔;舒张性心力衰竭;心脏功能;疗效;安全性
KEYWORDS: Metoprolol; Bisoprolol; Diastolic heart failure; Cardiac function; Efficacy; Safety
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