比索洛尔对慢性心力衰竭血液动力学和运动耐量的影响

Influence of Bisoprolol on Hemodynamic and Exercise Capacity with Chronic Heart Failure

目的 探讨比索洛尔对慢性心力衰竭 (CHF)早期和长期血液动力学和运动耐量的影响。方法 10 0例CHF患者对照组和治疗组各 5 0例 (NYHA分级Ⅱ -Ⅳ级 ) ,进入为期 1年的随机平行单盲对照研究。研究前先行 6min步行距离及运动峰耗氧量 (VO2MAX)测定 ,再测基线血液动力学参数。对照组口服稳定剂量的利尿剂、地高辛和血管紧张素转换酶抑制剂 (ACEI) ,治疗组在此基础上加服比索洛尔 1 2 5mg ,1次 /日 ,并在 6～ 8周达到靶剂量 10mg ,1次 /日 ,直到完成血液动力学测定和运动耐量试验 ,为期 1年。结果 治疗组早期血液动力学恶化 ,外周血管阻力 (SVR)增加 ,左室射血分数 (LVEF)下降 (P <0 0 5 ) ,两组患者长期血液动力学参数均有改善 (P <0 0 5 ) ,但组间比较心输出量 (CO)、心脏指数 (CI)、LVEF、6min步行距离、VO2MAX治疗组改善更加明显 (P<0 0 5 )。结论 比索洛尔可使CHF早期血液动力学恶化 ,但长期血液动力学参数和运动耐量可明显改善。

Objective To study the influence of bisoprolol on early or long-term hemodynamic and exercise capacity with chronic heart failure(CHF).Methods 100 CHF patients were divided into two groups,the contrast and the bisoprolol group,50 cases respectively(NYHA grading Ⅱ-Ⅳ),and were gone in the random parallel contrast blind studied duration one year.Distance of 6 minutes and maximum exercise volume of consuming Oxgen(VO 2MAX )were detected before researched and again measured the baseline of hemodynamic,then the contrast group administered stable dosage deuretic、digoxin and ACEI orally,the bisoprolol group administered bisoperolol orally,1.25mg per day again,and reached the target dosage 10mg per day least 6～8 week until completing hemodynamic and exercise test in one year.Results The bisoprolol group early hemodynamic effect worsens,surronding vessel resistarce(SVR) increase,Left ventricular ejection fraction(LVEF) decrease(P<0.05);The long-term hemodynamic of two groups were clear improvement(P<0.05),difference was notable between the two groups.cardic out put(CO),cardiac index(CI)、LVEF,VO 2MAX and the distance of 6 minutes were significantly improved(P<0.05).Conclusion The early hemodynamic of bisoprolol effect worsens,but the long-term hemodynamic and exercise capacity were significantly improved.