比索洛尔改善充血性心衰心功能及心肌重塑的疗效观察_医学论文.docVIP

比索洛尔改善充血性心衰心功能及心肌重塑的疗效观察_医学论文 比索洛尔改善充血性心衰心功能及心肌重塑的疗效观察_医学论文 作者：何争　贾国良　王海昌　冯旭阳　李寰　郭文怡 【关键词】心力衰竭 关键词:心力衰竭，充血性比索洛尔肾上腺素能β受体拮抗剂 摘要:目的观察比索洛尔（bisoprolol）对充血性心衰心功能及心肌重塑的临床疗效.方法212例患者随机分为比索洛尔组和常规药物组，比索洛尔剂量起始量0.625mg～1.250mg，1次#12539d-1，逐渐增加至最大剂量为2.5mg～5.0mg，1次#12539d-1.观察心功能、临床疗效、左室舒张末内径（LVEDD）、左室收缩末内径（LVESD）、射血分数（EF）、舒张早期E峰流速/舒张晚期A峰流速（VE/VA）.结果比索洛尔组与常规药物组比较，比索洛尔治疗3mo后有效者（87.7%）高于常规药物组（66.0%），0.05冠心病（87.9%）和扩张型心肌病心衰（91.9%）疗效明显好于常规药物组（分别为66.7%，67.4%）治疗6mo后重度心衰者疗效（90.0%）明显好于常规药物组（65.4%，0.05）.治疗后比索洛尔组LVESD［（44.8±3.9）mmvs（48.8±4.6）mm］，EF［（40.7±7.5）%vs（35.7±5.2）%］优于常规药物组（0.01）LVEDD，VE/VA也较治疗前有明显改善.结论比索洛尔改善充血性心力衰竭临床症状，促进心脏收缩、舒张功能恢复，部分逆转心肌重塑. 　　Keywords:heartfailure，congestivebisoprololadrenergicbeta-antagonists 　　Abstract:AIMToevaluatetheclinicaleffectofbisoprolol　onheartfunctionandmyocardialremodelingincongestiveheartfailure（CHF）.METHODS212patientswithchronicheartfailureofvariousetiologiesandtheleftventricularejec-tionfractionoflt40%randomlyenteredthebisoprololandcontrolgroups.Bisoprololwasadministeredorallyintheini-tialdoseof0.625～1.25mg#12539d-1andthen2.5～5mgwasinstilleddaily.Theheartfunction（NYHA）andparametersinhemodynamics（LVEDD，LVESD，EFandVE/VA）wereobserved.RESULTS3monthslater，theheartfunctionmorefavorablyimprovedinthebisoprololgroup（87.7%）thaninthecontrolgroup（66.0%，0.05）.Comparedwiththecontrolgroup，CHFduetocoronaryheartdisease（87.9%to66.7%，0.05）andidiopathicdilatedcar-diomyopathy（91.9%to67.4%，0.01）improvedsignifi-cantlyinthebisoprololgroup.6monthslater，theheartfunctionofpatientswithseriousCHFalsomorefavorablyim-provedinthebisoprololgroup（90%）thaninthecontrolgroup（65.4%，0.05）.LVESDwasshortenedobviouslyinthebisoprololgroupascomparedwiththecontrols［（44.8±3.9）vs（48.8±4.6）mm，0.01］，andEFwasenhancedinthebisoprololgroupascomparedwiththecon-trols［（40.7±7.5）%vs（35.7±5.2）%，0.01］.LVEDDandVE/VAgotbetterthanthoseofpre-therapy（0.01）.CONCLUSIONBisoprololmayrelievesymptoms，increasecardiacsystolicanddiastolicfunctions，andpartiallyregressmyocardialremodeling. 　　0引言 　　近年来，充血性心