舒张功能不全性心衰72例治疗体会

Experience of treating 72 cases of DHF

目的:对72例舒张功能不全性心衰患者进行临床分析。方法:在积极进行病因治疗的同时,应用利尿剂和硝酸酯类药物缓解症状,常规选用血管紧张素转换酶抑制剂(ACEI)或血管紧张素Ⅱ受体拮抗剂(ARB)、β受体阻滞剂及钙离子拮抗剂以改善左室舒张功能。人院时及治疗4周后分别行彩色多普勒超声心动图检查,用流速指标测定二尖瓣血流图E/A比值,并观察心功能(NYHA分级)改善情况。结论:舒张性心衰主要病因为高血压和冠心病,且随着年龄的增长,发病率呈增加趋势。房颤、心动过速可加重临床症状,应积极纠正,控制心室率在60～70次/min。小剂量开始应用利尿剂、硝酸酯类药物,β受体阻滞剂开始剂量较大,调整剂量不受时间限制。

Objective： To analyze 72 cases of DHF in patients. Methods： Active cause of treatment, at the same time, using diuretics and nitrates to relieve symptoms, the conventional choice of angiotensin-converting enzyme inhibitors （ACEI） or angiotensin Ⅱ receptor antagonist （ARB）, ,8 blockers agents and calcium channel blockers to improve left ventricular diastolic function. Color doppler echocardiography were performed after admission and treatment of four weeks, using flow rate indicator to determine the mitral rheogram E/A ratio, and to.observe the improvement of NYHA. Conclusion： Hypertension and coronary heart disease are the main causes of diastolic heart failure, and with the increase of age, the incidence rate showed an increasing trend. Atrial fibrillation, tachycardia may aggravate the clinical symptoms, should be actively corrected, the ventricular rate control in 60-70 beats/min. Dosage should be appropriate.