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目的 探讨不同剂量比索洛尔治疗对冠心病心力衰竭患者心功能及T淋巴细胞亚群的影响.方法 选取2014年6月-2016年1月本院收治的冠心病心力衰竭患者144例,随机分为低剂量组(n=48),中剂量组(n=48)和高剂量组(n=48),三组均给予相同剂量的曲美他嗪治疗,并分别联合2.5、5.0、7.5 mg/d的比索洛尔治疗.比较三组治疗前,治疗后1、3个月心功能指标和T淋巴细胞亚群的变化.结果 治疗后3个月三组左心室射血分数(LVEF)、左室短轴缩短分数(LVFS)、CD4+比例、CD4+/CD8+比值显著高于治疗前和治疗后1个月,左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD)显著低于治疗前和治疗后1个月,差异有统计学意义(P<0.05);高剂量组治疗后1、3个月LVEF、LVFS、CD4+比例、CD4+/CD8+比值显著高于低剂量组和中剂量组,LVESD、LVEDD显著低于低剂量组和中剂量组(P<0.05),且3组差异有统计学意义(P<0.05).结论 高剂量比索洛尔长疗程治疗冠心病心力衰竭可调节患者T淋巴细胞亚群比例,从而调节免疫功能,改善患者心脏功能.“,”Objective To explore the impact of different dosage of bisoprolol on T lymphocyte subsets and cardiac function in the treatment of coronary heart disease patients complicated with heart failure. Methods A total of 144 coronary heart disease patients complicated with heart failure were selected from June 2014 to January 2016,and they were randomly divided into low dose group(n=48),middle dose group(n=48)and high dose group(n=48). The 3 groups were treated with the same dose of trimetazidin,and combined with 2.5,5.0 and 7.5 mg/d bisoprolol,respectively. The changes of cardiac function indexes and T lymphocyte subsets proportions of the three groups were compared before and 1 and 3 months after treatment. Results Three months after treatment ,left ventricular ejective fraction (LVEF),left ventricular fraction shortening(LVFS),CD4+ratio and CD4+/CD8+ratio of the 3 groups were significantly higher than those of before treatment and 1 months after treatment,while left ventricular end systolic diameter (LVESD) and left ventricular end diastolic diameter(LVEDD)of the 3 group were significantly lower than those of before treatment and 1 months after treatment(P<0.05). LVEF,LVFS,CD4+ratio and CD4+/CD8+ratio of high dose group at 1 and 3 months after treatment were significantly higher than those of the low dose group and middle dose group. LVESD and LVEDD of high dose group at 1 and 3 months after treatment were significantly lower than those of low dose group and middle dose group (P<0.05). Conclusion High dose bisoprolol and long-course treatment could effectively adjust the T lymphocyte subsets and regulating the immune function,and improve the cardiac function of coronary heart disease patients complicated with heart failure,which is worthy of promotion.