比索洛尔治疗顽固性心力衰竭患者临床观察

Clinical observation on the effect of selective β-blocker bisoprolol on refractory heart failure

目的观察选择性β-受体阻滞剂比索洛尔治疗顽固性心力衰竭患者的临床效果。方法随机将顽固性心力衰竭患者100例分为β-受体阻滞剂治疗组和安慰剂对照组,两组年龄、心衰病程、原发病及心功能分级均具有可比性。在常规抗心衰治疗中,治疗组加服比索洛尔片剂,从小剂量1.25mg/d开始,缓慢加量至有效量或达2.5～5mg/d,对照组给予安慰剂1片/d,4周后观察两组NYHA心功能分级、左室射血分数(LVEF)、血压、心率和24h室性早搏>2 000次的发生率、病死率及副作用等。结果治疗组较对照组NYHA心功能分级、左室射血分数均有明显改善;血压、心率明显降低;室性早搏>2000次/24h的发生率、病死率明显下降(P<0.05)。结论除常规抗心衰治疗顽固性心力衰竭外加用比索洛尔可明显改善患者的心脏功能,提高患者的生活质量,并减少室性早搏的发生率,其副作用小,可作为顽固性心力衰竭治疗的首选辅助用药。

Objective To observe the efficiency of selective β-Blocker bisoprolol＇s effects on refractory heart failure patients.Methods The 100 patients with refractory heart failure received standard anti-heart-failure pharmacotherapy were randomly divided into bisoprolol group and placebo group（control group）.Patients in bisoprolol group were given bisoprolol beginning withlow dose of 1.25mg daily,and gradually added to 2.5~5mg daily when tolerated.Those in the control group were given one tablet of placebo daily.Four week after treatment HYHA heart function classification（Left ventricular eject fraction）LVEF,blood pressure,rate of ventricular premature more than 2 000/24hr in Holter test,mortality rate and adverse effects were compared between these two groups.Results Compared to control group,HYHA heart function classification,LVEF were better in bisoprolol group,and blood pressure,heart rate,rate of ventricular premature more than 2 000/24hr,mortality rate were statistically lower in bisoprolol group（P0.05）.Conclusions Bisoprolol could improve heart function,life quality,and decrease the rate of ventricular premature with few adverse effects and could be chosen as the first line medicine for treatment of refractory heart failure patients.