艾司洛尔、拉贝洛尔治疗缺血性心力衰竭的临床疗效比较

Clinical＇observation of the treatment of ischemic heart failure with combination therapy esmolol and labetalol

目的研究静脉注射艾司洛尔、拉贝洛尔治疗缺血性心力衰竭的疗效。方法缺血性心力衰竭（ICD）患者80例按数字表法随机分为治疗组1（20例）、治疗组2（20例）、治疗组3（20例）和对照组（20例）。治疗组1在常规治疗的基础上静脉注射艾司洛尔,治疗组2在常规治疗的基础上静脉注射拉贝洛尔,治疗组3在常规治疗的基础上静脉注射艾司洛尔和拉贝洛尔,对照组仅给予常规治疗。观察对比四组治疗效果,并记录患者治疗前后血压、心率、步行距离及超声心电图的变化。结果治疗组1显效3例,有效14例,有效率为85%;治疗组2显效2例,有效14例,有效率为80%;治疗组3显效4例,有效15例,有效率为95%;对照组显效1例,有效10例,总有效率为55%。治疗组1、2、3与治疗效果均优于对照组,差异有统计学意义（P〈0.05）;治疗组1、2与治疗组3相比治疗效果均有显著性降低（P〈0.05）;治疗组1、2相比治疗效果无显著性改变（P〉0.05）。四组患者经治疗后,均无出现恶心、呕吐等胃肠道反应及肝肾功能异常的不良反应,且观察指标如6min步行距离,左室射血分数（LVEF）、左心室缩短分数（FS）、每分搏出量（SV）等反应心功能的指标等均较治疗前有显著的改善（P〈0.05）。结论静脉注射艾司洛尔、拉贝洛尔或两者共同给药治疗缺血性心力衰竭能明显改善心功能,无不良反应,安全可靠,值得在临床上合理推广应用。

Objective To study the effect of intravenous injection of esmolol, labetalol and their combinationin the treatment of ischemic heart failure （ ICD） . Methods 80 patients with ICD were randomly divided into treatment group 1 （ 20 cases） , treatment group 2（ 20 cases） , treatment group 3 （ 20 cases） and control group（ 20 cases） .The treatment group 1 was intravenously given esmolol on the basis of routine treatment. the treatment group 2 wasintravenously given labetalol on the basis of the conventional treatment. the treatment group 3 was intravenously givenesmolol and labetalol on the basis of routine treatment. The control group only received routine treatment. The therapeutic effects of the four groups were observed and compared, and the changes of blood pressure, heart rate, walkingdistance and ultrasonic electrocardiogram before and after treatment were recorded. Results In the treatment group1, 3 cases with marked effect, effective in 14 cases, the total effective rate was 85%. In the treatment group 2, 2 caseswith marked effect, effective in 14 cases, the total effective rate was 80% cases. In the treatment group 3, 4 cases withmarked effect, effective in 15 cases, the total effective rate was 95%. In the control group, 1 case with marked effect,effective in 10 cases, the total effective rate was 55%. The treatment effect of the treatment group 1, 2, 3 was betterthan the control group （ P 〈0. 05） . The treatment effect of the treatment group 1, 2 was significantly lower than thetreatment group 3 （ P 〈 0. 05） . The treatment effect between the treatment group 1 and group 2 had no significantdifference （ P 〉0. 05） . After treatment, 6 min walking distance and LVEF, FS, SV and other indicators of cardiacfunction were significantly improved in the four groups（ P 〈 0. 05） . The four groups had no significant adversereactions such as nausea, vomiting, liver and renal function after treatment. Conclusion Intravenous injection ofesmolol, labetalol or both drugs for treatment of ICD can improve cardiac function, with no adverse reaction, and it issafe and reliable, worthy of clinical application.