倍他乐克对扩张性心肌病心功能及室性心律失常的影响

Clinical Efficiency of Betaloc in Dilated Cardiomyopathy Complicated by Heart Failure or Ventricular Arrhythmias

目的 分析倍他乐克治疗扩张性心肌病(DCM),对心功能及室性心律失常的影响。方法 将110例DCM分成两组,A组:52人(男性41,女性11),平均年龄44岁,左室射血分数(LVEF)平均 31．30％,以利尿剂,洋地黄和血管紧张素转换酶抑制剂(ACEI)等基础治疗;B组:58人(男性45,女性 13),平均年龄47岁,LVEF平均32．26％,在利尿剂和洋地黄ACEI综合治疗基础上,只要患者耐受,从 小剂量逐步加用倍他乐克12．5 mg／天至50～100 mg／天。结果 经过12个月治疗随访,两组共有24 例因心血管事件死亡(A组16,B组8);有27例因心衰加重,严重心律失常事件再次住院治疗(A组18, B组9)。治疗前后比较,B组较A组患者心率减慢,QT离散度(QTd)降低,LVEF明显增加,室性心律 失常得到更好控制,心功能明显改善。结论 倍他乐克可显著改善DCM患者的远期预后。

Objective To evaluate clinical efficacy of Betaloc in dilated cardiomyopathy （DCM） complicated by chronic heart failure or ventricular arrhythmias. Methods 110 cases with DCM was divided into two groups. A group：fifty tow case （male41,female 11） ,average age 44 years old and average EF 31.30 % ,was given to controlled therapy with diuretic, digitalis and angiotensin--converting enzyme inhibitor（ACEI） et,B group：fifty eight case （ male45,female 13）, average age of 47 years old and average EF 32.26 % ,Besides control therapy with diuretic,digitalis and ACEI, was given to therapy with Betaloc from 12.5 mg to 50-100 mg per day if they were tolerable. Results During 12 months following-up, 24patients （A group 16,B group 8） died due to cardiac events,and 27（ A group 18,B group 9） admitted again due to aggravated heart failure or severe ventricular arrhythmlc events. After treatment, B group compared with A group,heart rate and QTd reduced,left ventricular eject fraction （LVEF） increased, ventricular arrhythmias well-controlled. Conclusions The long-term prognosis could be improved by Betaloc in DCM patients.