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目的评价富马酸比索洛尔治疗缺血性心肌病患者室性心律失常和心力衰竭的临床疗效和安全性。方法选择心功能I~IV级缺血性心肌病合并室性心律失常患者125例,分为A、B两组。A组(治疗组)66例,予富马酸比索洛尔2.5~5mg/d和常规缺血性心肌病治疗;B组(对照组)59例,仅予常规缺血性心肌病药物治疗。在治疗开始和治疗后6个月进行心率、血压、动态心电图、超声心动图、心胸比率、肾功能以及心肌标志物的检查。结果两组控制室性心律失常的总有效率分别为78.79%和59.32%,有显著性差异(P<0.01)。左室舒张末容积(LVEDV)、左室收缩末期容积(LVESV)、左室射血分数(LVEF)和E/A(舒张早期血流速度峰值E峰/舒张晚期血流速度峰值A峰)改善情况治疗组优于对照组,有显著性差异(P<0.05);心率、血压、心胸比率在治疗前后以及两组之间均有显著性差异(P<0.05);同时治疗前和治疗后6个月监测肾脏功能和心肌标志物水平,治疗前后以及两组之间比较无显著性差异(P>0.05);不良反应无显著性差异(P>0.05),而病死率有显著性差异(P<0.05)。结论富马酸比索洛尔治疗缺血性心肌病患者室性心律失常和心力衰竭的效果明显,能够防止恶性心律失常的发生,使左室容积缩小、左室射血分数升高;心率和血压得到改善,心胸比率下降,降低缺血性心肌病患者的猝死率,不良反应小。
Objective To evaluate the clinical efficacy and safety of bisoprolol fumarate in the treatment of ventricular arrhythmia and heart failure in patients with ischemic cardiomyopathy. Methods A total of 125 patients with ischemic cardiomyopathy with ventricular arrhythmia of grade I ~ IV were divided into two groups: A and B. A group (treatment group) 66 cases, to bisoprolol fumarate 2.5 ~ 5mg / d and conventional ischemic cardiomyopathy treatment; B group (control group) 59 cases, only conventional ischemic cardiomyopathy drug treatment. Heart rate, blood pressure, Holter, echocardiography, cardiothoracic ratio, renal function, and myocardial markers were examined at the start of treatment and 6 months after treatment. Results The total effective rate of ventricular arrhythmia control was 78.79% and 59.32% in both groups, with significant difference (P <0.01). Left ventricular end-diastolic volume (LVEDV), left ventricular end systolic volume (LVESV), left ventricular ejection fraction (LVEF) and E / A (Peak A of early diastolic flow velocity peak / (P <0.05). The heart rate, blood pressure, cardiothoracic rate were significantly different between before and after treatment and between the two groups (P <0.05), while those in the treatment group were significantly higher than those in the control group There was no significant difference between before and after treatment and between the two groups (P> 0.05); there was no significant difference in adverse reactions (P> 0.05), but the mortality was significantly different (P <0.05). Conclusion Bisoprolol fumarate treatment of ischemic cardiomyopathy in patients with ventricular arrhythmias and heart failure, the effect is obvious, to prevent the occurrence of malignant arrhythmias, the left ventricular volume reduced, left ventricular ejection fraction increased; heart rate and blood pressure Be improved, cardiothoracic ratio decreased, reduce the rate of sudden death in patients with ischemic cardiomyopathy, adverse reactions.