β-受体阻滞剂结合常规药物治疗瓣膜性心脏病心衰的探讨

Study on Treatment of Heart Valve Disease with β-Receptor Blockaders plus Conventional Pharmacotherapy

目的观察β-受体阻滞剂对心脏瓣膜病合并重症心力衰竭患者血流动力学和心功能的影响。方法对31例风湿性心脏病合并重症心衰患者在常规抗心衰治疗基础上加用β-受体阻滞剂治疗,观察β-受体阻滞剂治疗前及治疗后1周、2周患者心率、血压、临床症状的改善情况。结果β-受体阻滞剂治疗后1周、2周,患者心室率明显下降(P<0.01),分别有41.9%和71.0%患者的心功能改善1级以上而不伴有收缩期及舒张期血压的变化。结论采用β-受体阻滞剂治疗心脏瓣膜病合并心衰,正确掌握适应证及β-受体阻滞剂用药剂量可取得良好治疗效果,但远期疗效需进一步观察。

Objective To investigate the effects of β- receptor blockaders on the hemodynamic and cardiac function of heart valve disease complicated with severe heart failure. Methods 31 patients with rheumatic heart disease complicated with server heart failure were treated with β- receptor blockaders on conventional pharmacotherapy, The changes of heart rate, blood pressure and clinical symptoms before treatment, and 1 week and 2 weeks after treatment were observed, Results The heart rates were significantly declined one week and two weeks after the β-receptor blockaders treatment （ P 〈0. 01 ） ; the patients whose cardiac function was improved by more than one grade without the change of blood pressure accounted for 41,9% and 70. 9% respectively. Conclusion β- receptor blockaders can effect a better cure for patients with rheumatic heart disease complicated with heart failure, but the long - time effect of β- receptor blockaders need to further investigated.