贝那普利联合比索洛尔治疗慢性充血性心力衰竭疗效观察

目的：观察贝那普利联合比索洛尔治疗慢性充血性心力衰竭（CHF）的疗效、安全性并探讨其作用机制。方法：将116例CHF病人随机分为治疗组（58例）和对照组（58例）；对照组给予强心、利尿剂、血管扩张剂等常规治疗，病情稳定后仅以地高辛和利尿剂有效剂量加以维持；治疗组在常规治疗心功能稳定基础上，从给予贝那普利5mgQd开始，逐周增加5mg，可用到20mg／d分二次服；比索洛尔2．5mg／d开始，逐周增加1．25mg，可用到10mg／d。分别于3个月后进行随访。治疗前、后对比心功能、实验室检查、心电图及超声心动图检查，运动耐量检测用6min步行试验，服药期间密切观察不良反应，每半月记录1次。结果：治疗组和对照组在治疗3个月～18个月随访期间，治疗组总有效率89．7％，对照组总有效率60．3％，有显著性差异（P〈0．01）。治疗组在改善心功能参数方面显著优于对照组（P〈0．05）。治疗组因心衰加重而再住院率和死亡率均低于对照组（P〈0．05）。未见明显毒副反应。结论：在传统的洋地黄和利尿剂治疗的基础上加用β受体阻滞剂、ACEI联用治疗CHF是有效的治疗方法，可提高患者运动耐量，降低其再住院率和死亡率。

Observe the curative effect of benazepril joint bisoprolol on chronic congestive heart failure

Objective： To observe the effect and safety of Benazepril plus Bisoprolol on chronic congestive heart failure （CHF） and its mechanism. Methods： 116 cases of CHF patients were randomly divided into treatment group （58cases） and the control group （58cases） ; The control group was treated with cardiocinetic, diuretics, blood vessel expansion agent et al conventional therapy and maintained by the digoxin and the diuretic in effective dose; the treatment group was treated with Benazepril 5 mgQd, case-by- week increased 5 mg, available to 20 mg/d at two oral administration in the stable heart foundation and was treated with Bisoprolol 2. 5 mg/d, case-by-week increased 1.25 mg, available to 10 mg/d, the tow groups was carried on the revisit after 3 months. The changes of heart function, the laboratory inspection, the electrocardiogram and the echocardiogram before and after the treatment were compared , the movement tolerance examination walks with 6min were experimented , Adverse drug reaction was recorded once each half a month during taking medicine. Results： During 3 month - 18 month follow-up period, the total efficiency of treatment group was 89. 7 percent, the total efficiency of the control group was 60. 3 percent, there was a significant difference （P 〈 0. 01 ） between two groups. The parameters of heart function of treatment group was better than the control group, re-hospitalization and mortality rates of treatment group due to heart failure aggravation were lower than the control group （ P 〈 0. 05 ）. No obvious toxic side effects. Conclusion： the digitalis and diuretic , combined with Beta acceptor retarder and ACEI unites on CHF treatment is the effective method , exercise tolerance of patients are improved and their re-hospitalization and mortality rates are reduced