张　桥，李春莉(云南省文山州人民医院心内科，云南 文山　666100)



比索洛尔联合厄贝沙坦治疗慢性心力衰竭的疗效观察

张桥*，李春莉(云南省文山州人民医院心内科，云南 文山666100)

DOI10.14009/j.issn.1672-2124.2016.03.015

摘要目的：探讨比索洛尔联合厄贝沙坦治疗慢性心力衰竭的临床疗效观察。方法：选择文山州人民医院2013年1月—2014年12月收治的106例慢性心力衰竭患者作为研究对象，按随机数字表法分为观察组和对照组，每组各53例。对照组患者口服比索洛尔进行治疗；在对照组治疗的基础上，观察组患者加用厄贝沙坦进行治疗。治疗8周后，比较2组患者临床疗效、治疗前后心功能变化和血清超敏C反应蛋白(hs-CRP)以及B型脑钠肽(BNP)水平变化情况，治疗前后收缩压(SBP)、舒张压(DBP)以及脉压差等指标。结果：观察组患者总有效率为92.45%(49/53)，明显高于对照组的79.24%(42/53)，差异有统计学意义(P<0.05)；治疗后，2组患者左室收缩末期内径(LVESd)、左室舒张末期内径(LVEDd)明显低于治疗前，左室射血分数(LVEF)明显高于治疗前，差异均有统计学意义(P<0.05)；观察组患者治疗后LVESd、LVEDd以及LVEF改善较对照组治疗后更加显著，差异有统计学意义(P<0.05)；治疗后，观察组患者hs-CRP、BNP水平明显低于对照组，差异有统计学意义(P<0.05)；与对照组患者治疗后比较，观察组治疗后SBP、DBP以及脉压差改善更加显著，差异有统计学意义(P<0.05)。结论：在常规治疗基础上，联合应用比索洛尔和厄贝沙坦共同治疗慢性心力衰竭可以显著改善患者的心功能，降低血清hs-CRP、BNP水平，稳定血压水平，疗效较好。

关键词厄贝沙坦； 比索洛尔； 慢性心力衰竭； 临床疗效

Observation on Efficacy of Bisoprolol Combined with Irbesartan in Treatment of 106 Cases of Chronic Heart Failure

ZHANG Qiao， LI Chunli(Dept.of Cardiology，Yunnan Wenshan People’s Hospital，Yunnan Wenshan 666100， China)

ABSTRACTOBJECTIVE：To observe the clinical efficacy of bisoprolol combined with irbesartan in treatment of chronic heart failure.METHODS:106 cases of chronic heart failure admitted into Yunnan Wenshan People’s Hospital from Jan.2013 to Dec.2014 were selected to be divided into observatio group and control group via the random number table，with 53 cases in each.The control group were treated with conventional western medicine method combined with oral bisoprolol.The observation group additionally received irbesartan based on the control group. After treatment of 8 weeks，the clinical efficacy，changes of heart function， changes of serum C reactive protein(hs-CRP) and B type natriuretic peptide (BNP) level，systolic blood pressure(SBP) and diastolic blood pressure(BNP)，and pulse pressure were compared between two group of patients before and after treatment.RESULTS:The total effective rate in observation group was significantly higher than that in control group [92.45%(49/53)VS 79.24%(42/53)]，the difference was statistically significant (P<0.05). After treatment，left ventricular end systolic diameter (LVESd)， left ventricular end diastolic diameter (LVEDd) of the two groups were significantly lower than those of before treatment，left ventricular ejection fraction (LVEF) was significantly higher than before treatment (P<0.05).The LVEF，LVEDd and LVESd of the observation group were significantly more than those of the control group (P<0.05).Levels of BNP and hs-CRP in observation group were significantly lower than those in control group (P<0.05).Compared with the control group after treatment，the SBP，DBP and pulse pressure of the observation group were significantly improved，the difference was statistically significant (P<0.05).CONCLUSIONS: On the basis of routine treatment，the combination of bisoprolol and irbesartan in treatment of chronic heart failure (CHF) can significantly improve the patient’s heart function and decrease serum hs-CRP and BNP levels，stable blood pressure level，so as to achieve more significant clinical effects.

KEYWORDSIrbesartan； Bisoprolol； Chronic heart failure； Clinical efficacy

慢性心力衰竭(chronic heart failure ,CHF)指的是由于心脏疾病、过度劳累等原因，导致心脏的排血功能减弱，使得排血量不能满足机体代谢的需要，导致肺循环和(或)体循环静脉淤血、组织灌注不足的一种疾病，是各种疾病导致心脏疾病的严重阶段[1-3]。随着心脏功能的逐渐衰退， CHF患者心脏每分输出量明显降低，血流动力学发生异常，导致神经-内分泌系统过度激活，发生水钠潴留、心脏负荷明显加重以及心室重构，心功能进一步的恶化[4]。2013年1月—2014年12月，云南省文山州人民医院(以下简称“我院”)在常规治疗的基础上联合应用厄贝沙坦以及比索洛尔治疗53例CHF患者，疗效较好，现报告如下。……