目的 观察比索洛尔与美托洛尔治疗慢性心力衰竭的疗效.方法 选取80例慢性心力衰竭患者,随机分为对照组及观察组,每组各40例,均给予血管紧张素Ⅱ受体拮抗剂(ARB)、利尿及强心药物、血管扩张等药物外,对照组加用美托洛尔,观察组加用比索洛尔,均系统治疗12周,观察治疗前后心功能及心率、血压等变化情况.结果 两组治疗后较治疗前心功能均有明显改善(P>0.05).两组患者治疗后左室收缩末期内径(LVESd)、左室舒张末期内径(LVEDd)及左室射血分数(LVEF)的改变情况均较本组治疗前明显改善,观察组治疗后12周的LVESd、LVEDd、LVEF均较对照组无显著差异(P>0.05),观察组总有效率为97.5%,对照组总有效率为92.5%,差异有统计学意义(P<0.05).两组患者治疗后均能有效降低心率(HR)、收缩压(SBP)、舒张压(DBP),两组患者治疗前后指标变化差异有统计学意义(P<0.05),观察组与对照组比较,HR、SBP、DBP变化差异有统计学意义(P<0.05),两组均未发生严重的药物不良反应.结论 比索洛尔与美托洛尔均能有效治疗慢性心力衰竭,但比索洛尔在减慢心率及降压方面效果明显优于美托洛尔.%Objective To observe the effect of bisoprolol and metoprolol in treating chronic heart failure. Methods 80 patients with chronic heart failure were randomly divided into control group and observation group,40 cases in each group. All patients were treated with ARB,diuretics, cardiotonic drugs and vasodilator drugs as the basis,control group plus metoprolol and observation group plus bisoprolol,both for 12 weeks,the changes of heart function , heart rate and blood pressure before and after treatment were observed. Results After treatment,the cardiac function of the two groups were significantly improved(P>0.05).Two groups of patients' left ventricular end systolic diameter(LVESd),left ventricular end diastolic diameter(LVEDd)and left ventricular ejection fraction(LVEF)changes after treatment were significantly improved compared with those before treatment,12 weeks after treatment of observation group,LVESd,LVEDd,LVEF were lower than those in the control group had no significant difference(P>0.05),the total efficiency of the observation group was 97.5%,control group total effective rate was 92.5%,the difference was statistically significant(P<0.05). Two groups of patients' heart rate(HR),systolic blood pressure(SBP)and diastolic blood pressure (DBP) significantly reduced after treatment,the difference was statistically significant before and after treatment in two groups(P<0.05). There were statistical significance differences of HR,SBP and DBP in observation group compared with the control group(P<0.05),the two groups had no serious adverse drug reactions. Conclusion Bisoprolol and metoprolol are effective in the treatment of chronic heart failure,heart rate and blood pressure,but the effect of bisoprolol in slowing heart rate and blood pressure is significantly better than metoprolol.
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