倍他乐克联合起搏器治疗缓室率心衰的疗效研究

目的　观察起搏器植入术后加服倍他乐克对缓慢心室率的慢性充血性心力衰竭 (CHF)患者的远期预后。方法　选择缓室率的CHF患者 75例 ,抗心衰综合治疗 2周后 ,分为对照组 ( 30例 )和治疗组 ( 4 5例 ) ,对照组继续上述疗法 ,治疗组在原基础上 ,行右心室起搏器 (VVI/VVIR)植入后服倍他乐克 ,观察治疗前和治疗后 3月～ 6月临床症状 ,心功能指标的情况。结果　与治疗前相比 ,治疗组心功能 (NYHA分级 )明显改善 ,从 2 84± 0 4 2缓解至 1 2 5± 0 76级 (P <0 0 1) ,6分钟步行距离延长 ,从 32 5± 4 5 6m增至 4 14± 34 9m(P <0 0 0 1) ,左室射血分数 (LVEF)及心输出量 (CO)均明显改善 ,分别为 0 38± 0 15比 0 4 5± 0 13;4 85± 0 84L比5 36± 0 98L(P <0 0 1)。对照组各指标改善无显著差异。结论　倍他乐克联合起搏器植入可显著改善缓室率心衰患者的心功能 ,提高病人生活质量

Long-term Effectiveness of Betaloc Combination with Pacemaker on Congestive Heart Failure Accompaning with Bradyrthythmia

Objective To investigate the long_term effects of Bataloc combination with Pacemaker in patients with chronic congestive heart failure (CHF) accompaning with bradyrhythmia. Methods after treated with general therapy for two weeks,75 CHF cases were divided into two groups:treatment group (45 cases) and control group (30 cases). Then all patients continued general therapy,but the patients in treatment group were orally given Betaloc for 3_6 months after right ventricular pacing (VVI/VVIR). All patients in both groups were evaluated clinical symptoms and heart function prior to and 3_6 months latter. Results According to New York Heart Association (NYHA) functional class,heart failure in treatment group decreased from 2 84±0 42 to 1 25±0 76 ( P <0 001),6 minutes walking distance increased from 325±45 6m to 414±34 9m ( P <0 001),leftventricular ejection fraction and output increased obviously (0 38±0 15 Vs 0 45±0 13;4 85±0 84L Vs 5 36±0 98L,respectively, P <0 01). But the control group did not change significantly. Conclusions Betaloc combination with pacemaker could improve heart function and quality of life.