β—受体阻滞剂在心力衰竭治疗中的应用研究(1)
[摘要] 目的 评价3种β-受体阻滞剂治疗慢性心力衰竭效果。方法 整群选取2012年3月—2014年1月该院收治的心力衰竭病例217例为研究对象，按不同治疗方法分为：50例患者应用酒石酸美托洛尔纳入A组，103例应用酒石酸美托洛尔缓释片纳入B组，64例应用富马酸比索洛尔片纳入C组，对比相关指标。结果 出院后，A、B、C组、合计心率达标率分别为36.0%、30.1%、20.3%、28.6%，高于入院前8.0%、5.8%、6.3%、6.5%，差异具有统计学意义(P<0.05)；出院后，A、B、C组平均剂量分别为(46.3±22.0) mg/d、(57.9±34.4) mg/d、(5.32±3.1) mg/d高于入院前(41.4±25.1) mg/d、(39.4±23.1) mg/d、(3.74±2.0) mg/d，差异具有统计学意义(P<0.05)。结论 住院CHF患者β-受体阻滞剂用药率较高，但剂量偏少，心率达标率较低，应尽量遵照指南推荐标准用药。
[关键词] 心力衰竭；β-受体阻滞剂；心率达标
[中图分类号] R541.6 [文献标识码] A [文章编号] 1674-0742(2016)01(a)-0026-03
Application Effect of Beta Blockers in the Treatment of Heart Failure
JIN Xiao-hui
Department of Cardiology， Heilongjiang Nongken Mudanjiang Administration Central Hospital， Jixi， Heilongjiang Province， 158300 China
[Abstract] Objective To evaluate the effects of three kinds of beta blockers in the treatment of chronic heart failure. Methods 217 case of heart failure in the hospital from March 2012 to January 2014 as the research objest，according to the different treatment methods were divided into 50 cases treated with metoprolol tartrate were selected as group A， 103 cases treated by metoprolol tartrate sustained-release tablets were selected as group B， and 64 cases treated by bisoprolol fumarate tablets were selected as group C. And the values of the relative indicators were compared between the groups. Results The rate of standard-achieving heart rate after discharge was higher than that before admission in group A(36.0% vs 8.0%)， group B(30.1% vs 5.8%) and group C(20.3% vs 6.3%) with statistically significant differences(P<0.05). The mean dosage after discharge was much more than that before admission in group A[(46.3±22.0) mg/d vs (41.4±25.1) mg/d]， group B[(57.9±34.4) mg/d vs (39.4±23.1) mg/d]， and group C[(5.32±3.1) mg/d vs (3.74±2.0) mg/d]， the differences were statistically significant(P<0.05). Conclusion The hospitalized CHF patients have high rate of using beta blockers， but the dose is too low， and the rate of standard-achieving heart rate is low， so it should be administered standardly in accordance with the recommendation of the guideline.
[Key words] Heart failure； Beta blockers； Standard-achieving heart rate
慢性心力衰竭(hronic heart failure，CHF)是心内科常见病、多发病，在我国35岁以上普通人群CHF发病率高达1.1%～1.5%，现存CHF患者超400万[1]。β-受体阻滞剂是心血管病治疗里程碑式药物，国外研究显示其可有效降低CHF病死率[2]。但遗憾的是，β-受体阻滞剂合理应用水平亟待提高，不按照指南推荐用药患者比重较高，医院治疗CHF选择β-受体阻滞剂较随意。该次研究试回顾性分析2012年3月—2014年1月黑龙江省农垦牡丹江管理局中心医院心力衰竭患者应用β受体阻滞剂情况，分析对比酒石酸美托洛尔患者、酒石酸美托洛尔缓释片、富马酸比索洛尔片3种常用β-受体阻滞剂在CHF治疗中的应用情况，评价院内用药疗效、合理水平，提出改进策略，现报道如下。 (靳晓慧)
[关键词] 心力衰竭；β-受体阻滞剂；心率达标
[中图分类号] R541.6 [文献标识码] A [文章编号] 1674-0742(2016)01(a)-0026-03
Application Effect of Beta Blockers in the Treatment of Heart Failure
JIN Xiao-hui
Department of Cardiology， Heilongjiang Nongken Mudanjiang Administration Central Hospital， Jixi， Heilongjiang Province， 158300 China
[Abstract] Objective To evaluate the effects of three kinds of beta blockers in the treatment of chronic heart failure. Methods 217 case of heart failure in the hospital from March 2012 to January 2014 as the research objest，according to the different treatment methods were divided into 50 cases treated with metoprolol tartrate were selected as group A， 103 cases treated by metoprolol tartrate sustained-release tablets were selected as group B， and 64 cases treated by bisoprolol fumarate tablets were selected as group C. And the values of the relative indicators were compared between the groups. Results The rate of standard-achieving heart rate after discharge was higher than that before admission in group A(36.0% vs 8.0%)， group B(30.1% vs 5.8%) and group C(20.3% vs 6.3%) with statistically significant differences(P<0.05). The mean dosage after discharge was much more than that before admission in group A[(46.3±22.0) mg/d vs (41.4±25.1) mg/d]， group B[(57.9±34.4) mg/d vs (39.4±23.1) mg/d]， and group C[(5.32±3.1) mg/d vs (3.74±2.0) mg/d]， the differences were statistically significant(P<0.05). Conclusion The hospitalized CHF patients have high rate of using beta blockers， but the dose is too low， and the rate of standard-achieving heart rate is low， so it should be administered standardly in accordance with the recommendation of the guideline.
[Key words] Heart failure； Beta blockers； Standard-achieving heart rate
慢性心力衰竭(hronic heart failure，CHF)是心内科常见病、多发病，在我国35岁以上普通人群CHF发病率高达1.1%～1.5%，现存CHF患者超400万[1]。β-受体阻滞剂是心血管病治疗里程碑式药物，国外研究显示其可有效降低CHF病死率[2]。但遗憾的是，β-受体阻滞剂合理应用水平亟待提高，不按照指南推荐用药患者比重较高，医院治疗CHF选择β-受体阻滞剂较随意。该次研究试回顾性分析2012年3月—2014年1月黑龙江省农垦牡丹江管理局中心医院心力衰竭患者应用β受体阻滞剂情况，分析对比酒石酸美托洛尔患者、酒石酸美托洛尔缓释片、富马酸比索洛尔片3种常用β-受体阻滞剂在CHF治疗中的应用情况，评价院内用药疗效、合理水平，提出改进策略，现报道如下。 (靳晓慧)