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find Keyword "β受体阻滞剂" 2 results
  • Effects of βreceptor Blocker on Intraventricular Pressure Gradient after Aortic Valve Replacement

    Abstract: Objective To investigate the effects of βreceptor blocker on intraventricular pressure gradient and left ventricle remodeling after valve replacement for critical aortic stenosis. Methods Fifty-six patients with critical aortic stenosis underwent aortic valve replacement surgery from January 2008 to January 2010 in the First Affiliated Hospital of Zhengzhou University. Thirtytwo of them who were followed up were selected to be enrolled in this study. The patients were divided into two groups under the same basis of clinical features. Twelve patients in the experimental group received oral βreceptor blocker (Metoprolol, 6.2525.00 mg once, twice daily). The rest 20 patients in the control group had no βreceptor blocker. The various indicators of ultrasound cardiogram (UCG) shortly after operation (within a week) and long after operation (6-24 months) were compared between the two groups. Results No death occurred in both groups, and chest distress, shortness of breath and other symptoms were obviously alleviated. Although left ventricular endsystolic dimension (LVESD) and left ventricular outflow tract dimension (LVOTD) of both groups increased 6-24 months after operation, compared with the early postoperative period, only the increase of LVOTD in the experimental group showed statistical difference (t=-47.937, P=0.001). In both groups, interventricular septum thickness (IVST), left ventricular posterior wall thickness (LVPWT), filament band velocity of left ventricular outflow tract (V), intraventricular pressure gradient (G) and left ventricular mass index (LVMI) of the later period after operation were significantly lower than those of the early postoperative period. All these indicators in the experimental group showed significant differences (t=7.781, P=0.001;t=5.749, P=0.001; t=2.637, P=0.023; t=7.167, P=0.001; t=100.061, P0.001), while only V, G, and LVMI showed statistical differences in the control group (t=4.051, P=0.001; t= 4.759, P= 0.001; t=-0.166,P=0.001). EF in the experimental group also indicated significant difference compared with early period after aortic valve replacement (t=-6.621, P=0.001). EF between two groups indicated no significant difference (t=-0.354,P=0.726). But differences between the two groups in LVEDD, IVS, G, and LVMI were all statistically significant in the later period after surgery (t=-2.494, P=0.018; t=-3.434, P=0.002;t=-2.171,P=0.038; t=-2.316, P=0.028). Conclusion β-receptor blocker is a safe and reliable drug for those patients who have undergone aortic valve replacement surgery for critical aortic stenosis, and can decrease significantly the residual intraventricular pressure gradient and accelerate left ventricular cardiac remodeling. 

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  • 血管紧张素转换酶抑制剂与β受体阻滞剂对心瓣膜置换术后心脏结构及功能的影响

    目的 探讨血管紧张素转换酶抑制剂(ACEI)和β-受体阻滞剂对心瓣膜置换术后患者心脏结构和功能的影响。 方法 选择2009年4~10月南华大学附属第一医院心瓣膜病患者60例,男28例,女32例;年龄19~66岁(46.25±11.59岁)。风湿性病变52例,先天性心脏病3例,退行性病变5例。行二尖瓣置换术37例,主动脉瓣置换术15例,二尖瓣和主动脉瓣双瓣膜置换术8例。根据术后给予的辅助药物不同将60例患者分为3组,每组20例。A组:术后给予强心、利尿药治疗;B组:术后给予强心、利尿药和ACEI治疗;C组:术后给予强心、利尿药、ACEI和β-受体阻滞剂治疗。分别于心瓣膜手术术前、术后2周、8周和16周检测3组患者的超声心动图指标。 结果 术后2周3组右心室舒张期末内径(RVEDD)和左心室短轴缩短率(LVFS)较术前有所下降(Plt;0.05)。A组术后8周和16周左心房内径(LAD)和RVEDD与术后2周差异无统计学意义(Pgt;0.05),而LVFS较术后2周有所提高(Plt;0.05)。B组和C组术后8周和16周LAD和RVEDD呈进行性下降,而LVFS呈进行性升高(Plt;0.05),与术前比较均明显增高(Plt;0.05);且C组LVFS改善程度优于B组(Plt;0.05)。 结论 心瓣膜病患者行人工机械瓣置换术后给予常规强心、利尿治疗外,辅以ACEI和/或β-受体阻滞剂治疗可能更有助于改善心脏功能和结构。ACEI+β-受体阻滞剂联合使用较单独使用ACEI对心瓣膜置换术后患者心功能的恢复更有帮助。

    Release date:2016-08-30 05:57 Export PDF Favorites Scan
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