比索洛尔治疗重度慢性心脏衰竭的近期疗效

Immediate and short-term efficacy of bisoprolol plus conventional therapy for severe chronic heart failure

目的 :在传统治疗方法基础上 ,探讨加用比索洛尔治疗伴心动过速重度慢性心脏衰竭的近期效果及其安全性 .方法 :住院重度心衰患者 110例 ,NYHA心功能 4级 ,平静 30min后心率≥ 10 0次·min-1,除外严重低血压及显著心脏阻滞患者 ,随机分为 :①常规治疗组 (n =5 3) ,应用ACE抑制剂、利尿剂、洋地黄等治疗 .②比索洛尔组 (n =5 7)在同常规组治疗基础上加用比索洛尔 .比较两组住院死亡、病情恶化、心脏阻滞的新发或加重的例数 ,平静 30min后心率减慢至 80次·min-1的时间 ,症状控制时间及住院时间等 .结果 :两组均无病情恶化及死亡病例 ,比索洛尔组在心率控制时间、症状控制时间以及住院时间等诸方面显著优于常规组 .比索洛尔组 1例发生AVBIII度 ,1例原AVBI度者恢复正常 .结论

AIM: To investigate the immediate and short term efficacy and safety of bisoprolol plus ACE inhibitors, diuretics, and digoxin in treating patients with unstable chronic heart failure. METHODS: 110 in patients with severe heart failure(NYHA class IV)without severe hypotension and heart block were divided randomly into conventional therapy group treated with ACE inhibitors, diuretics and digoxin, and bisoprolol group treated with the same as conventional group but plus bisoprolol (Bosu, Bei Jing Shihuan Pharmacy). After therapy, the number of in hospital deaths, deterioration of heart failure, heart block, the time needed to decrease the heart rate to 80 bpm, the time needed to improve the symptoms and the duration of hospitalization were compared between the two groups. RESULTS: There was no in hospital death and deteriorating case in the two groups. Compared with those in the conventional group, the heart rate was better controlled, the symptoms were better improved and duration of hospitalization was shortened in bisoprolol group. One patient suffered from AVBIII0 after therapy but another patient suffering from AVBI0 before therapy was completely recovered in bisoprolol group. CONCLUSION: Bisoprolol plus conventional therapy has an excellent immediate and short term efficacy in patients with severe chronic heart failure.