关键词: 心力衰竭，充血性;比索洛尔;肾上腺素能β受体拮抗剂

    摘 要:目的 观察比索洛尔(bisoprolol)对充血性心衰心功能及心肌重塑的临床疗效. 方法 212例患者随机分为比索洛尔组和常规药物组，比索洛尔剂量起始量0.625mg～1.250mg，1次·d-1 ，逐渐增加至最大剂量为2.5mg～5.0mg，1次·d-1 .观察心功能、临床疗效、左室舒张末内径(LVEDD)、左室收缩末内径(LVESD)、射血分数(EF)、舒张早期E峰流速/舒张晚期A峰流速(VE/VA). 结果 比索洛尔组与常规药物组比较，比索洛尔治疗3mo后有效者(87.7%)高于常规药物组(66.0%)，P<0.05;冠心病(87.9%)和扩张型心肌病心衰(91.9%)疗效明显好于常规药物组(分别为66.7%，67.4%);治疗6mo后重度心衰者疗效(90.0%)明显好于常规药物组(65.4%，P<0.05).治疗后比索洛尔组LVESD [(44.8±3.9)mm vs(48.8±4.6)mm]，EF[(40.7±7.5)%vs(35.7±5.2)%]优于常规药物组(P<0.01);LVEDD，VE/VA也较治疗前有明显改善. 结论 比索洛尔改善充血性心力衰竭临床症状，促进心脏收缩、舒张功能恢复，部分逆转心肌重塑.

    Effects of bisoprolol on heart function and myocar┐dial remodeling in patients with congestive heart failure

    HE Zheng，JIA Guo-Liang，WANG Hai-Chang，FENG Xu-Yang，LI Huan，GUO Wen-Yi

    Department of Cardiovasology，Xijing Hospital，Fourth Military Medical University，Xi'an710033，China

    Keywords:heart failure，congestive;bisoprolol;adrenergic beta-antagonists

    Abstract:AIM To evaluate the clinical effect of bisoprolol on heart function and myocardial remodeling in congestive heart failure(CHF).METHODS 212patients with chronic heart failure of various etiologies and the left ventricular ejec-tion fraction of<40%randomly entered the bisoprolol and control groups.Bisoprolol was administered orally in the ini-tial dose of0.625～1.25mg·d-1 and then2.5～5mg was instilled daily.The heart function(NYHA)and parameters in hemodynamics(LVEDD ......