倍他乐克治疗慢性心力衰竭的疗效观察

目的观察倍他乐克治疗慢性心力衰竭的疗效及安全性。方法46例慢性心力衰竭(CHF)患者随机分为常规治疗组(ACEI+利尿剂+地高辛)和倍他乐克治疗组(在充分使用上述药物治疗的基础上加用倍他乐克),随访半年,观察两组治疗前后血流动力学、心功能分级、左心室射血分数、左心室内径的变化。结果①治疗后两组静息状态下的心率、收缩压均较治疗前明显下降,而倍他乐克治疗组的下降程度[(78.2±6.0)次/min,收缩压(123.1±11.1)mmHg)]显著高于常规治疗组[(84.3±7.0)次/min,收缩压(130.9±6.6)mmHg);②治疗后,两组的LVESD、LVEDD均较治疗前下降,LVEF升高(P<0.01),而治疗后倍他乐克治疗组的LVESD、LVEDD的下降程度[分别为(41.9±2.7)mm、(58.7±2.1)mm、LVEF升高(49.5±12.1)%]均较常规治疗组治疗后明显[分别为(46.9±3.7)mm、(64.5±2.2)mm,LVEF升高(40.4±11.3)%;P<0.01]。结论β受体阻滞剂倍他乐克治疗慢性心力衰竭有效,可以改善心功能和临床症状,延缓心室重塑,阻止心脏扩大,从小剂量开始,严密观察心率、血压及临床症状,逐渐增加到最大耐受量,是非常安全的。

Clinical effect of betaloc on chronic heart failure

Objective To study the clinical effect of betaloc on chronic heart failure(CHF).Methods Forty-six patients with CHF were randomized into two groups:twenty patients(regular treatment group) were treated with ACEI+digoxin+diuretic,and the other patients(Betaloc treatment group) were treated with Betaloc in addition to the above regular treatment.All the patients were followed up for half a year,then the changes of heart rate,blood pressure,NHYA class,internal diameter of left ventricle and LVEF were observed.Results ①HR,SBP of all the patients decreased significantly after treatment(P<0.01),particularly in Betalo group,there was significant difference in the descending of HR,SBP between the Betaloc group [HR(78.2±6.0)次/min,SBP(123.1±11.1) mmHg)] and regular treatment group(HR(84.3±7.0)次/min,SBP(130.9±6.6) mmHg);②LVESD,LVEDD of all the patients reduced,the LVEF increased significantly after treatment,particularly in Betaloc group,there was significant difference in the reduction of LVESD,LVEDD,and the increase of LVEF between Betaloc group [LVESD(41.9±2.7) mm,LVEDD(58.7±2.1) mm,LVEF(49.5±12.1)%] and regular treatment group [LVESD(46.9±3.7) mm,LVEDD(64.5±2.2) mm,LVEF(40.4±11.3]%(P<0.01).Conclusion β receptor blocker Betaloc is effective on chronic heart failure,it can improve heart function,relieve clinical symptoms,delay ventricle remodeling and prevent heart expansion.The drug is safe when it is given begin from small dosage and increase the amount gradually until the maximun bearable dosage is reached,and the rhythm of heart,blood pressure and clinical symptoms must be paid close attention.