比索洛尔治疗稳定性心力衰竭的临床疗效

BISOPROLOL FOR PATIENTS WITH STABLE HEART FAILURE

目的观察比索洛尔治疗稳定性心力衰竭的临床疗效。方法76例稳定性心力衰竭患者在常规治疗心衰的基础上,随机分成比索洛尔组39例和对照组37例,治疗组口服比索洛尔1.25～5.00mg/天,对照组口服安慰剂,疗程6个月。观察治疗前后心率、左室舒张末期内径、左室射血分数和6min步行距离。结果比索洛尔治疗组2个月后气促症状明显改善、心率明显下降(p<0.05);4个月后左室射血分数和6min步行距离明显改善(p<0.05),6个月后左室射血分数和6min步行距离明显进一步改善(p<0.01);6个月后左室舒张末期内径明显缩小(p<0.05)。安慰剂对照组治疗4月心率才显著下降(p<0.05),左室射血分数和6min步行距离治疗6月明显改善(p<0.05),左室舒张末期内径随访有缩小,但无统计学差异(p>0.05)。与对照组比较,比索洛尔治疗组因心衰再次入院、心血管死亡率、总死亡率复合终点明显减少(p<0.05)。结论比索洛尔治疗稳定性心力衰竭有效安全。

Objective To investigate the efficacy and safety of bisoprolol for patients with chronic heart failure. Methods 76 stable patients with heart failure under conventional treatment were randomly divided into bisoprolol group （ n = 39） and placebo （ n = 37 ）, once daily bisoprolol （ 1.25 - 5 mg） was given to bisoprolol group. The heart rate,left ventricular ejection fraction（LVEF） ,left ventricular end diastolic diameter（LVEDd） and 6 - min walk- ing distance were observed. Results 2 months after the initiation of bisoprolol treatment, dyspnea improved, heart rate reduced significantly （p 〈 0.05 ） ; 4 months after treatment, left ventricular ejection fraction and 6 -min walking distance improved significantly （p 〈 0.05 ） and p 〈 0.01 after 6 months ; 6 months after treatment, left ventricular end diastolic diameter reduced significantly （p 〈 0.05 ）. In placebo group, heart rate reduced significantly （p 〈 0. 05 ） 4 months after treatment, 6 months after treatment, left ventricular ejection fraction and 6 - min walking distance improved significantly （p 〈 0.05 ）, left ventricular end diastolic diameter reduced, but it was not significantly （p 〉 0. 05）. Compared with placebo, composite end points （rehospitalization, cardiovascular mortality and total mortality） in bisoprolol group reduced significantly（p 〈 0.05）. Conclusions Bisoprolol is effective and safe for patients with stable heart failure.