心力衰竭时交感神经和肾上腺素能系统活动增强是维持心排血量和辅助周围循环功能的一种重要代偿机制。然而,近年来的研究证明,交感神经和肾上腺素能系统的长期代偿性机能亢进反而对心肌产生直接的抑制作用,并导致心肌功能发生进行性损伤,这种改变不利于慢性充血性心力衰竭的长期预后。因此,如何控制心力衰竭的病情进展以降低其远期死亡率成为临床研究的主要方向。自1998年7月我们利用小剂量美多心安治疗慢性充血性心力衰竭,进行了30个月的疗效观察,现将结果报告如下。 1 对象与方法 1.1 对象:本组42例患者符合(NY HA)心功能分级标 Increased sympathetic and adrenergic system activity during heart failure is an important compensatory mechanism for maintaining cardiac output and supporting peripheral circulation. However, recent studies have shown that long-term compensatory hyperactivity of the sympathetic and adrenergic systems, on the contrary, exerts a direct inhibitory effect on the myocardium and leads to progressive damage of myocardial function, which is not conducive to chronic congestive heart failure Long-term prognosis. Therefore, how to control the progress of heart failure to reduce its long-term mortality has become the main direction of clinical research. Since July 1998 we use a small dose of Metoprolol in the treatment of chronic congestive heart failure, the efficacy of 30 months of observation, the results are reported as follows. 1 objects and methods 1.1 Object: The group of 42 patients with NYHA heart function grading