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比索洛尔联合常规三联疗法对风湿性心脏瓣膜病合并慢性心力衰竭患者疗效及相关指标的影响
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| 篇名： | 比索洛尔联合常规三联疗法对风湿性心脏瓣膜病合并慢性心力衰竭患者疗效及相关指标的影响 |
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| 摘要： | 目的：探讨比索洛尔联合常规三联疗法对风湿性心脏瓣膜病（RVD）合并慢性心力衰竭患者疗效及相关指标的影响。方法： 110例RVD合并慢性心力衰竭患者随机分为观察组（55例）和对照组（55例）。两组患者均给予吸氧、抗感染，纠正电解质紊乱、控制心律失常，同时服用洋地黄类药物、利尿药（水肿症状控制后可停用）等常规治疗。在此基础上，对照组患者口服马来酸依那普利片初始剂量2.5 mg，每日1～2次，1周后逐渐调整剂量至10～20 mg， 每日2次+螺内酯片20 mg，每日1次+盐酸普萘洛尔片10 mg，每日1次；观察组患者在对照组治疗的基础上口服富马酸比索洛尔片初始剂量1.25 mg，每日1次，根据病情改善及耐受性酌情加量至10 mg，每日1次。两组均治疗12周。观察两组患者的临床疗效，治疗前后的左心室射血分数（LVEF）、左心室舒张末期内径（LVEDD）、左心室收缩末期内径（LVESD）、收缩压（SBP）、舒张压（DBP）、心率（HR）及不良反应发生情况。结果：观察组患者总有效率显著高于对照组，差异有统计学意义（P＜0.05）。治疗前，两组患者LVEF、LVEDD、LVESD、SBP、DBP、HR比较，差异均无统计学意义（P＞0.05）。治疗后，两组患者LVEF均显著高于同组治疗前，且观察组高于对照组；LVEDD、LVESD、SBP、DBP、HR均显著低于同组治疗前，且观察组低于对照组，差异均有统计学意义（P＜0.05）。两组患者不良反应发生率比较，差异无统计学意义（P＞0.05）。结论：在常规治疗的基础上，比索洛尔联合常规三联疗法用于RVD合并慢性心力衰竭疗效显著，可改善患者心功能，且安全性较好。 |
| ABSTRACT： | OBJECTIVE： To observe the effects of bisoprolol combined with conventional triple therapy on the efficacy and related indexes of patients with rheumatic heart valvular disease （RVD） combined chronic heart failure. METHODS： 110 patients with RVD combined with chronic heart failure were randomly divided into observation group （55 cases） and control group （55 cases）. All patients were treated with oxygen inhalation， anti-infection， correcting electrolyte imbalance， controlling arrhythmia， and giving digitalis drugs and diuretic drugs （it can be disabled after edema symptom being controlled）； based on it， control group was given Enalapril tablet with initial dose of 2.5 mg， once to twice a day， then adjusted to 10-20 mg after 1 week， twice a day+20 mg Spironolactone tablet， once a day+10 mg Propranolol tablet， once a day. Observation group was additionally given Bisoprolol fumarate tablet initial dose of 1.25 mg， once a day， and then increased to 10 mg based on condition improved and tolerability after a meal， once a day. They were treated for 12 weeks. Clinical efficacy， and LVEF， LVEDD， LVESD， SBP， DBP， HR before and after treatment and incidence of adverse reactions in 2 groups were observed. RESULTS： The total effective rate in observation group was significantly higher than control group， the difference was statistically significant （P＜0.05）. Before treatment， there were no significant differences in the LVEF， LVEDD， LVESD， SBP， DBP and HR between 2 groups （P＞0.05）. After treatment， LVEF in 2 groups were significantly higher than before， and observation group was higher than control group， LVEDD， LVESD， SBP， DBP and HR were significantly lower than before， and observation group was lower than control group， the differences were statistically significant（P＜0.05）. And there was no significant difference in the incidence of adverse reactions（P＞0.05）. CONCLUSIONS： Based on conventional treatment， bisoprolol combined with conventional triple therapy shows good efficacy in the treatment of RVD combined chronic heart failure， it can improve cardiac function， with good safety. |
| 期刊： | 2016年第27卷第18期 |
| 作者： | 蒋芳萍，宁靓，杨波 |
| AUTHORS： | JIANG Fangping，NING Liang，YANG Bo |
| 关键字： | 比索洛尔；依那普利；螺内酯；三联疗法；风湿性心脏瓣膜病；慢性心力衰竭 |
| KEYWORDS： | Bisoprolol； Enalapril； Spironolactone； Triple therapy； Rheumatic heart disease； Chronic heart failure |
| 阅读数： | 296 次 |
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