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目的探讨美托洛尔缓释片对血流储备分数(FFR)>0.80冠心病患者心功能的影响。方法选取孙逸仙心血管医院2012—2015年收治的FFR>0.80的冠心病患者81例,随机分为对照组39例和观察组42例。在常规治疗基础上,对照组患者给予安慰剂,观察组患者给予美托洛尔缓释片;两组患者均连续治疗3个月。比较两组患者治疗后心率、血压(收缩压、舒张压)、心功能分级,治疗前及治疗后1、2、3个月心功能指标〔左心房内径(LAD)、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、左房室瓣-室间隔间距(EPSS)、左心室短轴缩短率(LVFS)、左心室质量(LVM)、左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)和左心室射血分数(LVEF)〕,随访3个月期间再入院情况。结果观察组患者治疗后心率、收缩压、舒张压低于对照组,心功能分级优于对照组(P<0.05)。时间与方法在LVEDD、LVESD、LVFS、LVEDV、LVESV、LVEF上存在交互作用(P<0.05),在LAD、EPSS、LVM上无交互作用(P>0.05);时间在LAD、LVEDD、LVESD、EPSS、LVFS、LVM、LVEDV、LVESV、LVEF上主效应显著(P<0.05);方法在LAD、LVEDD、LVESD、EPSS、LVFS、LVM、LVEDV、LVESV、LVEF上主效应显著(P<0.05);治疗后1个月观察组患者LVESD低于对照组(P<0.05);治疗后2个月观察组患者LAD、LVEDD、LVESD、LVEDV低于对照组,LVFS、LVEF高于对照组(P<0.05);治疗后3个月观察组患者LAD、LVEDD、LVESD、EPSS、LVM、LVEDV、LVESV低于对照组,LVFS、LVEF高于对照组(P<0.05)。观察组患者随访期间再入院率低于对照组(P<0.05)。结论美托洛尔缓释片可有效降低FFR>0.80冠心病患者心肌耗氧量,抑制患者心室重构并改善患者心功能。
Objective To investigate the effects of metoprolol sustained-release tablets on cardiac function in patients with coronary heart disease (FFR)> 0.80. Methods 81 cases of CHD patients with FFR> 0.80 from 2012 to 2015 in Sun Yat-sen Cardiovascular Hospital were randomly divided into control group (n = 39) and observation group (n = 42). On the basis of routine treatment, patients in the control group were given placebo, while patients in the observation group were given metoprolol sustained-release tablets. Both groups were treated for 3 months continuously. Heart rate, blood pressure (systolic blood pressure, diastolic blood pressure), heart function grading, heart function indexes (left atrium diameter (LAD), left ventricular end-diastolic diameter LVEDD, LVESD, EPSS, LVFS, LVM, LVEDV, LVEDD, LVEDD, LVEDD, LVEDD, Left ventricular end-systolic volume (LVESV) and left ventricular ejection fraction (LVEF)] were followed up for 3 months. Results After treatment, heart rate, systolic pressure and diastolic blood pressure in observation group were lower than those in control group, and heart function classification was superior to control group (P <0.05). There was no interaction between LAD, EPSS and LVM (P> 0.05); the time was on LAD, LVEDD, LVESD, LVFS, LVEDV, LVESV and LVEF (P <0.05). The main effect was significant (P <0.05) on LAD, LVEDD, LVESD, EPSS, LVFS, LVM, LVEDV, LVESV and LVEF; The LVESD in the observation group was lower than that in the control group one month after surgery (P <0.05). The levels of LAD, LVEDD, LVESD and LVEDV in the observation group were lower than those in the control group at 2 months after treatment (P <0.05) ; LAD, LVEDD, LVESD, EPSS, LVM, LVEDV and LVESV in the observation group were lower than those in the control group and LVFS and LVEF in the observation group at 3 months after treatment (P <0.05). The readmission rate of patients in observation group during follow-up was lower than that in control group (P <0.05). Conclusion Metoprolol sustained release tablets can effectively reduce myocardial oxygen consumption in patients with FFR> 0.80 coronary heart disease, inhibit ventricular remodeling and improve cardiac function in patients.