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目的:观察比索洛尔对老年高血压患者舒张性心力衰竭(DHF)的临床疗效。方法:入选老年高血压患者83例,按纽约心脏协会(NYHA)心功能分级Ⅱ～Ⅳ级,主要表现为舒张功能不全,随机分成比索洛尔干预组42例及对照组41例,两组患者均给予抗高血压及抗心力衰竭(CHF)的常规治疗,但对照组不用β受体阻滞剂。比索洛尔干预组患者加用比索洛尔1.25～10.00mg/d,疗程6个月。比较两组患者治疗前后NYHA心功能分级及左室超声舒张功能指标改善情况。结果:比索洛尔干预组总有效率为95%;对照组总有效率为80%,两组比较有显著性差异(P<0.05)。治疗后左室等容松弛减慢指标等容舒张时间(IVRT);左室早期充盈减慢指标二尖瓣舒张早期血流最大速度E峰、舒张早期和晚期充盈速度比值(E/A),E峰减速时间(DT);以及左室前后径(LAD),收缩压、舒张压、心率(HR)等左心室舒张功能指标明显优于治疗前(P<0.01);比索洛尔干预组IVRT、E、E/A、DT、LAD、HR等改善明显优于对照组。结论:比索洛尔治疗老年高血压患者的舒张性心力衰竭可显著降低心率、降压,改善心功能分级和左室舒张功能。
Objective: To observe the clinical efficacy of bisoprolol in elderly hypertensive patients with diastolic heart failure (DHF). Methods: Eighty-three elderly hypertensive patients were enrolled in this study. According to the New York Heart Association (NYHA) cardiac function classⅡ-Ⅳ, diastolic dysfunction was randomly divided into 42 cases of bisoprolol intervention group and 41 cases of control group. Both were given conventional antihypertensive and anti-heart failure (CHF) therapies, but the control group did not use beta-blockers. Bisoprolol intervention group patients with bisoprolol 1.25 ~ 10.00mg / d, treatment for 6 months. The NYHA functional class and left ventricular diastolic function were compared between two groups before and after treatment. Results: The total effective rate of Bisoprolol intervention group was 95%. The total effective rate of control group was 80%. There was significant difference between the two groups (P <0.05). The left ventricular isovolumic relaxation slowing index (IVRT), the early left ventricular filling slowing index (E), the early diastolic and late filling velocity ratio (E / A) (DT), left ventricular diastolic time (DT), left ventricular diastolic function (LAD), systolic pressure, diastolic pressure and heart rate (HR) were significantly higher than those before treatment (P <0.01) , E, E / A, DT, LAD, HR and other improvements were significantly better than the control group. Conclusion: Bisoprolol treatment of elderly patients with diastolic heart failure can significantly reduce heart rate, blood pressure, improve cardiac function and left ventricular diastolic function.