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近年来我院用地高辛加小剂量倍他乐克治疗顽固性心衰30例,27例获得满意疗效,报告如下。 1 临床资料 1.1 一般资料 本组30例中男18例,女12例。年龄16～76岁(平均54.6岁)。患者均经休息、正性肌力药、利尿剂,扩血管药以及有关病因,诱因的治疗,均不能满意控制心衰,按NYHA分级分别为Ⅲ级20例,Ⅳ级10例。伴房颤13例,房性早搏3例,房、室性早搏2例。均有心脏扩大。病因:扩张性心肌病5例,高血压性心脏病5例。冠心病6例,甲亢性心脏病2例,风湿性心脏病12例。 1.2 方法 在应用强心、利尿、扩血管的基础上,加用小剂量倍他乐克12.5mg/d,根据病情调整剂量(6.25～100mg/d)。以最小有效量维持4～6周。逐日记录症状、体征、心率、血压及副作用。疗效判定:心加用倍他乐克后,心功能改善两级以上者为显效.改
In recent years, our hospital with digoxin and small doses of metoprolol treatment of refractory heart failure in 30 cases, 27 cases were satisfied with the results, the report is as follows. 1 Clinical data 1.1 General Information The group of 30 patients, 18 males and 12 females. Age 16 to 76 years (mean 54.6 years). Patients were rest, inotropic drugs, diuretics, vasodilators and the treatment of causes, incentives are not satisfied with the control of heart failure, according to NYHA grade were grade Ⅲ 20 cases, Ⅳ grade 10 cases. Atrial fibrillation in 13 cases, atrial premature beats in 3 cases, room, ventricular premature beats in 2 cases. Have heart enlargement. Etiology: Dilated cardiomyopathy in 5 cases, 5 cases of hypertensive heart disease. 6 cases of coronary heart disease, hyperthyroidism heart disease in 2 cases, 12 cases of rheumatic heart disease. 1.2 Methods In the application of cardiac, diuretic, vasodilator based on the use of small doses of metoprolol 12.5mg / d, according to adjust the dose (6.25 ~ 100mg / d). The minimum effective amount to maintain 4 to 6 weeks. Daily recording of symptoms, signs, heart rate, blood pressure and side effects. Efficacy of the decision: Heart plus Betaloc, heart function improved more than two were markedly effective