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目的:观察不同剂量的比索洛尔对舒张性心力衰竭患者左室舒张功能的影响。方法:92例高血压病并发左室舒张功能不全但左室射血分数(LVEF)>50%的患者,在氨氯地平控制血压达标(<140/90 mmHg)的基础上,按照加用比索洛尔的剂量随机分为3组:对照组(不用比索洛尔组,n=31),低剂量组(加用比索洛尔1.25 mg,1次/d,n=30),高剂量组(加用比索洛尔5 mg,1次/d,n=31),平均随访观察30周。采用超声多普勒心动图评估治疗前后左室结构和功能参数的变化。结果:3组治疗后LVEF和收缩压无明显改变,舒张压和心率在低剂量组和高剂量组下降明显(P<0.05)。加用比索洛尔治疗后,患者E峰、A峰、E/A、E峰流速积分(VTIE)、A峰流速积分(VTIA)、流速时间积分比率(E-VTI/A-VTI)有不同程度改善,高剂量组较低剂量组改善更加显著(P<0.05)。左室舒张末内径(LVEDD)、室间隔厚度(IVSD)、左室后壁厚度(PWT)、左室质量指数(LVMI)在高剂量组变化显著(P<0.05),对照组无显著改善。结论:在氨氯地平降压达标基础上,比索洛尔能够进一步改善高血压病患者左室舒张功能,较大剂量作用更加显著。
Objective: To observe the effects of different doses of bisoprolol on left ventricular diastolic function in patients with diastolic heart failure. Methods: A total of 92 hypertensive patients with left ventricular diastolic dysfunction but left ventricular ejection fraction (LVEF)> 50% were treated with amlodipine (<140/90 mmHg) The doses of lolol were randomly divided into three groups: control group (no bisoprolol group, n = 31), low dose group (with bisoprolol 1.25 mg once daily, n = 30), high dose group Add bisoprolol 5 mg once a day, n = 31). The patients were followed up for an average of 30 weeks. Changes of left ventricular structure and function parameters before and after treatment were evaluated by echocardiography Doppler echocardiography. Results: There was no significant change of LVEF and systolic pressure after treatment in three groups. The diastolic blood pressure and heart rate decreased significantly in low dose group and high dose group (P <0.05). After bisoprolol treatment, the E-peak, A-peak, E / A, E peak VTIE, VTIA, E-VTI / A-VTI were different The improvement was more significant in the high-dose group than in the low-dose group (P <0.05). LVEDD, IVSD, PWT and LVMI were significantly different in high dose group (P <0.05), and no significant improvement in control group. Conclusion: Bisoprolol can further improve left ventricular diastolic function in patients with essential hypertension based on the standard of amlodipine antihypertension, and the effect of higher dose is more significant.