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采用亚极量踏车运动试验观察18例扩张型心肌病(DCM)心衰患者在长期应用美托洛尔后运动耐量和神经体液因子的变化;结果显示:给予平均剂量42.26±38.01mg/d,观察4.4±13.5月后DCM的患者总运动时间显著延长,最大作功量及耗氧量峰值均明显增加;同时血浆去甲肾上腺素、血管紧张素Ⅱ、心钠素显著降低,淋巴细胞β受体密度则增高。但治疗前运动耐量与这些体液因子无显著相关性,提示美托洛尔改善了DCM心衰患者的运动耐量,其机制可能与过度激活神经体液的抑制无直接关系,推测骨骼肌血流灌注及肌肉本身病变的改善可能是直接因素。
The submaximal treadmill exercise test was used to observe the changes of exercise tolerance and neurohumoral fluid in 18 patients with dilated cardiomyopathy (DCM) heart failure after long-term use of metoprolol. The results showed that the average dose of 42.26 ± 38.01mg / D, observed 4. 4 ± 13.5 months in patients with DCM significantly prolonged exercise time, the maximum amount of work and peak oxygen consumption were significantly increased; while plasma norepinephrine, angiotensin Ⅱ, atrial natriuretic peptide Significantly decreased lymphocyte beta receptor density is increased. However, there was no significant correlation between exercise tolerance and these humoral factors before treatment, suggesting that metoprolol improves exercise tolerance in DCM patients with heart failure. The mechanism may be related to the over-activation of neurohumoral inhibition. Improvement of the muscle itself may be the direct cause of disease.