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目的比较卡托普利与美托洛尔治疗慢型克山病的临床疗效及对患者心脏功能的影响。方法选择2014年1月~2015年12月在本院治疗的慢性克山病患者64例,根据随机数字表分为卡托普利组(n=32)和美托洛尔组(n=32)。两组患者均进行常规基础治疗,卡托普利组在基础治疗的基础上应用卡托普利,美托洛尔组在基础治疗措施的基础上使用美托洛尔。治疗后分别对两组患者死亡情况,临床症状改善情况以及心功能改善情况进行评估。结果卡托普利组病死率为3.13%,美托洛尔组无死亡。美托洛尔组治疗后心悸发生率显著高于卡托普利组(χ2=5.411,P<0.05);卡托普利组治疗后气促和咳嗽发生率均显著高于美托洛尔组(P<0.05)。治疗后两组患者心动过速、口唇发绀、以及浮肿等体征的发生率均较治疗前显著降低(P<0.05)。治疗后两组患者LVESD和LVEDD均较治疗前显著降低(P<0.05),LVEF均较治疗前显著升高(P<0.05)。组间比较,治疗前后两组患者LVESD,LVEF和LVEDD比较差异均无统计学意义(P>0.05)。组间比较,治疗前后两组患者心功能分级比较差异无统计学意义(P>0.05)。结论卡托普利和美托洛尔均可显著改善慢型克山病患者心功能,缓解临床症状,但两种药物对部分临床症状的缓解作用存在差异。
Objective To compare the clinical efficacy of captopril with metoprolol in the treatment of chronic Keshan disease and its effect on cardiac function. Methods Sixty-four patients with chronic Keshan disease who were treated in our hospital from January 2014 to December 2015 were divided into captopril group (n = 32) and metoprolol group (n = 32) according to the random number table . Both groups received routine basic treatment. Captopril group received captopril on the basis of basic treatment, and metoprolol group received metoprolol on the basis of basic treatment. After treatment, the deaths of two groups, the improvement of clinical symptoms and the improvement of cardiac function were evaluated. Results The mortality rate was 3.13% in captopril group and no death in metoprolol group. The incidence of palpitations in metoprolol group was significantly higher than that in captopril group (χ2 = 5.411, P <0.05). The incidences of dyskinesia and cough in captopril group were significantly higher than those in metoprolol group (P <0.05). After treatment, the incidences of tachycardia, cyanosis of the lips and edema in both groups were significantly lower than those before treatment (P <0.05). LVESD and LVEDD in both groups after treatment were significantly lower than those before treatment (P <0.05), and LVEF were significantly higher than those before treatment (P <0.05). There were no significant differences in LVESD, LVEF and LVEDD between the two groups before and after treatment (P> 0.05). There was no significant difference in cardiac function between the two groups before and after treatment (P> 0.05). Conclusions Both captopril and metoprolol can significantly improve cardiac function and relieve clinical symptoms in patients with chronic Keshan disease, but there are differences between the two drugs in relieving some clinical symptoms.