曲美他嗪治疗充血性心力衰竭的疗效观察

目的观察曲美他嗪（TMZ）治疗充血性心力衰竭（CHF）患者的疗效。方法选择78例充血性心力衰竭患者随机分为治疗组和对照组各39例。对照组：常规给予洋地黄类制剂、利尿剂、血管扩张剂、血管紧张素转换酶抑制剂及β-受体阻滞剂等药物。治疗组：在常规治疗基础上加用TMZ（2mg tid）连服3个月。结果两组心功能较治疗前有明显改善，治疗组临床总有效率为94．9％，较对照组．（79．5％）显著提高（P〈0．05），超声心动图各项指标改善（P〈0．05）。病情恶化减少（P〈0．05）。结论充血性心力衰竭患者长期服用曲美他嗪可使心功能改善，安全有效。     

米力农微泵治疗充血性心力衰竭的疗效观察

目的观察米力农微泵治疗充血性心力衰竭患者的临床疗效。方法充血性心力衰竭患者88例分别应用常规治疗（对照组）及常规治疗＋米力农微泵治疗（治疗组）,观察治疗前后心功能变化,并进行超声心动图检查,采用双抗夹心免疫荧光法检测脑钠肽（BNP）。结果治疗组显效率高于对照组（P〈0．01）。超声心动图显示,治疗组治疗后心脏每搏量、心输出量、左室射血分数较治疗前明显升高（P〈0．05）,BNP水平低于治疗前及对照组治疗后（P〈0．01）。结论米力农能改善心脏收缩、舒张功能,且有扩张血管的作用,对充血性心力衰竭患者有明显疗效。     

米力农与洋地黄治疗充血性心力衰竭的疗效分析

目的探讨米力农与洋地黄治疗充血性心力衰竭的疗效。方法选取2014年1月~2016年1月于我院就诊的充血性心力衰竭患者76例,随机均分为对照组与观察组,各38例。对照组患者予以洋地黄治疗,观察组予以米力农治疗,对比疗效。结果观察组治疗后总有效率89.5%与对照组84.2%对比,差异无统计学意义(P0.05)。而观察组显效率68.4%明显高于对照组44.7%(P0.05);观察组经治疗后CI(心脏指数)、LEVF(扩张型心肌病)、CO(心输出量)心功能指标较对照组更高,组间差异有统计学意义(P0.05)。结论米力农较洋地黄应用于充血性心力衰竭治疗时可有效改善心功能指标,疗效显著,值得推广。     

氨力农与洋地黄治疗充血性心力衰竭患者的疗效比较

比较氨力农与洋地黄治疗充血性心力衰竭患者的疗效。方法：选择４２例充血性心力衰竭患者,随机分为氨力农组;洋地黄组（ｎ＝１６）;对照组（ｎ＝１０）。分别用氨力农（２００ｍｇ＋ＮＳ２５０ｍｌ,以５－１０ｍｇ．ｋｇ＾－１．ｍｉｎ＾－１速度静滴）;洋地黄（地高辛０．１２５－０．２５ｍｇ／ｄ口服）;对照组仅口服和静注利尿剂和安慰剂,疗程均为１０天。治疗前后观察患者的心功能级别并作心脏超心功能指数测定。结果：氨     

培哚普利对充血性心力衰竭患者的影响

目的：观察培哚普利对充血性心力衰竭患者的影响。方法：对30例充血性心力衰竭患者在常规强心、利尿、扩血管治疗基础上，加用培哚普利；另外30例充血性心力衰竭患者为对照组，进行常规抗心力衰竭治疗。比较两种方法治疗心力衰竭后心功能的变化。结果：治疗组心功能改善总有效率（93．3％），左室射血分数（58％），明显高于对照组（P〈0．05）。结论：培哚普利对充血性心力衰竭患者能明显改善心功能，心力衰竭的症状。     

厄贝沙坦联合加味生脉散治疗慢性充血性心力衰竭的临床研究

目的探讨厄贝沙坦联合加味生脉散治疗慢性充血性心力衰竭（CHF）的疗效。方法将90例CHF病人随机分为两组，治疗组口服厄贝沙坦与加味生脉散，对照组口服厄贝沙坦。结果治疗10周后，两组心功能均明显改善，但治疗组心功能改善显效率为41．3％，优于对照组的22．7％（P〈0．05）。两组治疗后左房内径（IA）、左室舒张末期容积（LVEDV）、左室收缩末期容积（LⅦSV）均较治疗治疗前明显缩小（P〈0．05或P〈0．01），但治疗组明显优于对照组（P〈0．05）。结论厄贝沙坦联合加味生脉散治疗CHF优于单用厄贝沙坦治疗。     

硝普钠并多巴胺治疗重症充血性心力衰竭临床观察

目的：研究硝普钠并多巴胺治疗重症充血性心力衰竭的临床疗效。方法：重症充血性心力衰竭患者64例,在常规治疗（吸氧、洋地黄制剂、利尿剂）的基础上,随机、双盲地给予硝普钠或硝酸甘油,按1：1随机分为硝酸甘油组（对照组）和硝普钠组（治疗组）,两组均联合应用多巴胺,用药前后检查超声心动图评估心功能,监测肝、肾功能,心率,血压变化及预后。结果：与硝酸甘油组比较,硝普钠并多巴胺治疗组患者的临床症状明显改善（93．8％：78．1％,P〈0．01）,治疗后两组收缩压、舒张压明显下降,左室舒张末内径明显缩小,左室射血分数明显加强（P均〈0．01）,且硝普钠组优于对照组（P〈0．05）。结论：使用血管扩张剂硝普钠,联合多巴胺治疗重症充血性心力衰竭有较好的协同作用,可有效地减轻心脏负荷,改善心脏收缩功能,而且患者的耐受性好,较为安全。     

益心舒胶囊对慢性充血性心力衰竭患者心功能及血浆脑钠肽的影响

目的观察益心舒胶囊对慢性充血性心力衰竭（CHF）患者心功能及血浆脑钠肽（BNP）的影响。方法入选慢性充血性心力衰竭患者80例,随机分为两组,对照组给予常规的抗心力衰竭治疗,治疗组在对照组基础上加用益心舒胶囊。3个月为1个疗程。分别于治疗前后观察两组6min步行试验（6MWT）、超声心动图、血浆BNP水平变化。结果治疗组总有效率为82．5％,高于对照组的60．0％（P〈0．05）。治疗组治疗后心功能较治疗前明显改善（P〈0．05）,BNP水平均较治疗前明显下降（P〈0．05）;与对照组治疗后比较,治疗组心功能改善更明显（P〈0．05）,血浆BNP下降幅度更大（P〈0．05）。结论益心舒胶囊联合常规抗心力衰竭药物治疗能有效改善CHF患者心功能,降低血浆BNP水平。     

难治性心力衰竭患者的米力农治疗及护理

目的 探讨米力农治疗难治性充血性心力衰竭的效果和护理。方法 对48例充血性心力衰竭患者，心功能Ⅲ级以上，应用洋地黄效果不佳，给予米力农静脉注射5天，观察用药前后血压、心率、呼吸困难和水肿的变化情况。结果 米力农临床有效率为75％，6例患者血流动力学改善明显。结论 米力农治疗难治性心衰有较好的疗效，但必须同时做好米力农用药的观察和护理。     

门冬氨酸钾镁注射液治疗充血性心力衰竭98例疗效观察

目的观察门冬氨酸钾镁注射液治疗充血性心力衰竭的效果。方法将98例充血性心力衰竭的患者随机分为两组，对照组47例，给予常规抗心衰治疗；治疗组51例，在对照组基础上加用门冬氨酸钾镁治疗。结果治疗组总有效率（92．16％），明显高于对照组（74．46％）。结论常规抗心衰治疗的基础上联合门冬氨酸钾镁注射液治疗充血性心力衰竭有利于心功能的改善，进一步提高患者的生活质量，疗效肯定。     

OSAHS对老年慢性心力衰竭患者心功能的影响

目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)对老年慢性心力衰竭患者(CHF)心功能的影响。方法根据60例老年CHF患者的多导睡眠图监测将其分为CHF合并OSAHS组和CHF组,对比分析左心室射血分数(LEVF)、呼吸暂停低通气指数(AHI)、最低血氧饱和度(miniSPO2)及氧减饱和度指数(ODI)。结果与老年CHF组相比,观察组的LVEF较低且随AHI指数的增加而逐渐降低,两者呈负相关;miniSPO2以及ODI与AHI呈正相关。结论 OSAHS会加重老年CHF患者心功能的恶化,且会随其严重程度的增加而加剧。     

ACE抑制剂在充血性心力衰竭治疗中的地位

本文分析了从1985年1月至1996年12月间在我院住院治疗的充血性心力衰竭(CHF)患者共824例,并对其中应用血管紧张素转移酶抑制剂(ACEI)治疗的323例(A组)和不用ACEI治疗的501例(B组)进行了比较研究.结果表明A组低钾、镁血症的发生率较B组低;A组洋地黄中毒发生率为45.8%,较B组60.2%低;应用ACEI后室性律失常的发生率显著的降低.提示应用小剂量的开搏通和地高辛,加上利尿剂并补充钠盐、钾盐及镁剂等综合治疗处理,有助于降低CHF患者的洋地黄毒性反应和室性心律失常发生率,提高生存率.     

比索洛尔对慢性充血性心力衰竭患者心率震荡的影响

目的观察慢性充血性心力衰竭（CHF）者心率震荡（HRT）现象的特点,以及比索洛尔治疗后HRT的变化。方法测定和比较58例CHF者和41例健康体检者（C组）室性早搏后的震荡初始（TO）和震荡斜率（TS）值;并将CHF者随机分为比索洛尔治疗组（A组）和对照组（B组）。A组在B组常规治疗基础上加用比索洛尔口服,所有CHF者分别于治疗4w后复查24h动态心电图（DCG）。结果 C组TO〈0,而CHF患者TO〉0;CHF患者的TS明显低于健康体检者。CHF患者治疗4周后,HRT均有明显改善：TO下降,TS升高,但A组较B组改善明显,P〈0.05。结论 CHF者中HRT现象明显减弱;比索洛尔能改善其HRT,减少恶性室性心律失常的发生,改善患者的心功能。     

黄芪注射液对老年CHF心功能及血液流变学的影响

目的　观察黄芪注射液对老年充血性心力衰竭 (CHF)患者的心功能及血液流变学的影响 ,并探讨该药在CHF治疗中的应用价值。　 方法 　 10 2例老年CHF患者随机分为 2组 ,其中A组 5 0例在洋地黄、利尿剂和血管扩张剂治疗的基础上加用黄芪注射液静滴 ;B组 5 2例仅给洋地黄、利尿剂和血管扩张剂。 2组均连续用药 2周。用药前后进行多普勒超声心动图和血液流变学检查。　 结果　A组治疗后患者心排量、心脏指数和射血分数均明显增加 ,血液流变学各指标亦明显改善 ,与治疗前比较差异有显著性 (P <0 0 1或 <0 0 5 ) ,与B组比较差异亦有显著性 (P <0 0 5 )。A组的临床显效率和总有效率分别为 5 2 0 %和 90 0 %;B组为 2 8 8%和 6 7 4 %,2组比较差异有显著性 (P <0 0 5 )。治疗期间未见黄芪注射液不良反应。　 结论 　黄芪注射液有增强心功能和改善血液流变学作用 ,是辅助治疗老年CHF的一种有效而安全的药物。     

静脉应用速尿的不同方式对充血性心力衰竭疗效的影响

目的：观察静脉泵人与静脉注射速尿治疗中重度充血性心力衰竭（CHF）的临床效果。方法：86例CHF患者被随机分为静脉泵入组与静脉注射组,各43例。两组均给予心衰的基础治疗,静脉泵入组速尿100mg／d,20mg／h持续静脉泵人5h．静脉注射组100mg／d,1次静注。共观察7d,治疗前后测体重、左室射血分数（LVEF）、心输出量（CO）、6min步行距离。结果：静脉泵入组总有效率为88．4％,静脉注射组的79．1％,差异有显著性（P〈0．05）。静脉泵入组体重、LVEF、CO、6min步行距离改善明显优于静脉注射组（P〈0．05）。结论：静脉泵人速尿治疗CHF的疗效优于静脉注射。     

Effect of propranolol after acute myocardial infarction in patients with congestive heart failure

The incidence of congestive heart failure was studied in the Beta Blocker Heart Attack Trial in which postmyocardial infarction patients between the ages of 30 and 69 years, with no contraindication to propranolol, were randomly assigned to receive placebo (n = 1921) or propranolol 180 or 240 mg daily (n = 1916) 5 to 21 days after admission to the hospital for the event. Survivors of acute myocardial infarction with compensated or mild congestive heart failure, including those on digitalis and diuretics, were included in the study. A history of congestive heart failure before randomization characterized 710 (18.5%) patients: 345 (18.0%) in the propranolol group and 365 (19.0%) in the placebo group. The incidence of definite congestive heart failure after randomization and during the study was 6.7% in both groups. In patients with a history of congestive heart failure before randomization, 51 of 345 (14.8%) in the propranolol group and 46 of 365 (12.6%) in the placebo group developed congestive heart failure during an average 25 month follow-up. In the patients with no history of congestive heart failure, 5% in the propranolol group developed congestive heart failure and 5.3% in the placebo group developed congestive heart failure. Baseline characteristics predictive of the occurrence of congestive heart failure by multivariate analyses included an increased cardiothoracic ratio, diabetes, increased heart rate, low baseline weight, prior myocardial infarction, age, and more than 10 ventricular premature beats per hour.(ABSTRACT TRUNCATED AT 250 WORDS)     

Congestive heart failure and left ventricular dysfunction complicating doxorubicin therapy. Seven-year experience using serial radionuclide angiocardiography

To impact on the development of clinical congestive heart failure as a complication of doxorubicin therapy, left ventricular ejection fraction was monitored with serial resting radionuclide angiocardiography in 1,487 patients with cancer over a seven-year period in both university and community hospital environments. A high-risk subset of 282 patients was selected for retrospective analysis of their clinical outcome. High-risk patients were identified by one or two of the following three criteria: decline of 10 percent or more in absolute left ventricular ejection fraction from a normal baseline to 50 percent or less; high cumulative dose of doxorubicin (more than 450 mg/m2); abnormal baseline left ventricular ejection fraction (less than 50 percent). Clinical congestive heart failure occurred in 46 (16 percent) during the treatment period, and in an additional three patients (1.3 percent) at last follow-up examination 11.8 +/- 14.2 months following discontinuation of doxorubicin. Total cumulative dosages of doxorubicin that precipitated congestive heart failure (75 to 1,095 mg/m2) and those that did not (30 to 880 mg/m2) varied widely. Decline of 10 percent or more in absolute left ventricular ejection fraction to a value of 50 percent or less preceded administration of the final dose of doxorubicin that precipitated clinical congestive heart failure in the majority of patients in whom congestive heart failure developed. Clinical congestive heart failure improved in 87 percent given routine therapy with digitalis, diuretics, and/or vasodilators. Criteria for monitoring left ventricular ejection fraction and discontinuing doxorubicin were formulated. The occurrence of clinical congestive heart failure was compared in those patients whose management was concordant with proposed criteria (Group A) and in those whose management was not (Group B). Group A had a lower incidence of congestive heart failure compared with Group B (2.9 percent versus 20.8 percent, p less than 0.001) and had only mild congestive heart failure that resolved with treatment (n = 2) and no deaths due to congestive heart failure. Multivariate analysis with proportional-hazards regression (Cox's model) demonstrated a fourfold reduction in the incidence of congestive heart failure independent of other clinical predictor variables in those patients whose management was concordant with proposed guideline criteria. The incidence, persistence, late development, predictability, and reversibility of clinical congestive heart failure were comparable in university and community hospital settings.(ABSTRACT TRUNCATED AT 400 WORDS)     

托拉塞米注射液在充血性心力衰竭患者中的短期应用

目的通过对比托拉塞米与呋塞米的利尿作用，探讨托拉塞米注射液在充血性心力衰竭患者短期应用价值。方法选取充血性心力衰竭患者50例，随机分为托拉塞米组（24例）和呋塞米组（26例），在常规抗心衰治疗基础上，两组分别用托拉塞米注射液20mg／d与呋塞米注射液40mg／d治疗，连用3d。观察比较两组患者治疗前后尿量、体重、血钾的变化和不良反应。结果治疗3d后，与呋塞米组比较，托拉塞米组尿量明显增多，体重减轻明显（P均〈0．05）；托拉塞米组血钾下降较少，差异有统计学意义（P〈0．05）。结论托拉塞米注射液短期治疗充血性心力衰竭利尿效果优于呋塞米，低血钾副作用轻，不良反应少于呋塞米。     

乌拉地尔与硝普钠治疗顽固性心力衰竭的对比研究

目的观察乌拉地尔与硝普钠治疗顽固性心力衰竭的疗效。方法对72例顽固性心力衰竭患者在综合治疗的基础上分别应用硝普钠（36例）与乌拉地尔治疗（36例）。疗程7—10d。结果乌拉地尔组总有效率（88．6％）显著高于硝普钠组（80％）；两组治疗前后的脑钠肽（BNP）、心功能状况、血压及心率、呼吸频率均可得到明显的改善。但乌拉地尔可以更明显地改善心功能。结论在综合治疗的基础上应用乌拉地尔治疗顽固性心力衰竭。较硝普钠更明显地改善心功能，且具有更高的临床有效率，无明显的毒副作用。     

The Administration and Effect of Sodium Nitroprusside in the Treatment of Chronic Congestive Heart Failure

To prove the effectiveness and safety of sodium nitroprusside (SNP) in the treatment of chronic congestive heart failure, 58 patients with heart failure and normal renal and hepatic function were selected and divided into 3 groups and treated differently. Group A was treated with routine vasodilators; Group B was treaeted intermittently with SNP (12. 5 -75mg/24hrs); Group C was treated continuously with SNP (continuous infusion of 100 - 300mg/24hrs) Positively inotropie agents and diuretic agents were used in each group. The results showed that the highly effective rates of the three groups were 46. 9% (15/32), 90. 5% (19/21) and 100% (12/12) respectively. The effective rates were 81.3% (26/32), 100% (21/21), 100% (12/12) respectively. The highly effective rates of group B and C were much higher than that of group A ( P < 0. 005, P < 0. 005) . The reduction of blood pressure of group B and C was greater than that of group A ( P < 0. 025) . Among the patients we studied, no body had severe side effects.