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目的:探讨应用美托洛尔和卡托普利治疗扩张型心肌病(DCM)目的在于能否减轻免疫介导心肌损伤及改善慢性心室重构。方法:73例确诊为扩张型心肌病的患者,随机分3组:对照组为常规治疗;治疗1组在对照组的治疗基础上加用美托洛尔;治疗2组在治疗1组的治疗基础上同时加用卡托普利。观察治疗前后的心率(HR)、心胸比、血压、左室腔舒张末内径(LVDd)、左室射血分数(LVEF)的变化以及不良反应。结果:①治疗组治疗前后HR、心胸比与治疗前均有明显下降(P<0.01),LVDd、LVEF差异有统计学意义(P<0.05);②治疗1组无心衰组好转较心衰组更显著;治疗2组有心衰组好转较无心衰组更显著;③不良反应与药物剂量的增加有关。结论:应用美托洛尔及卡托普利对DCM的干预治疗,可以改善预后,改善扩张型心肌病的慢性心室重构。
Objective: To explore the application of metoprolol and captopril in the treatment of dilated cardiomyopathy (DCM) with the purpose of reducing immune-mediated myocardial injury and improving chronic ventricular remodeling. Methods: A total of 73 patients diagnosed with dilated cardiomyopathy were randomly divided into 3 groups: the control group received conventional treatment; the other 1 group received metoprolol on the basis of the control group; the other 2 groups were treated in the treatment group 1 Based on the addition of captopril. Heart rate (HR), cardiothoracic ratio, blood pressure, left ventricular end-diastolic diameter (LVDd), left ventricular ejection fraction (LVEF) changes and adverse reactions were observed before and after treatment. Results: ① The heart rate before and after treatment in treatment group was significantly lower than that before treatment (P <0.01), and the difference of LVDd and LVEF was statistically significant (P <0.05); ② The improvement of heart failure rate Group more significant; treatment group 2 heart failure group improved more significantly than no heart failure group; ③ adverse reactions and drug dose increase. Conclusion: The intervention of metoprolol and captopril on DCM can improve the prognosis and improve the chronic ventricular remodeling of dilated cardiomyopathy.