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目的观察培哚普利、比索洛尔治疗扩张型心肌病并充血性心力衰竭的疗效和对其预后进行综合评估。方法通过对已经确诊扩张型心肌病合并心力衰竭患者58例,根据患者意愿和经济情况分成治疗组A(38例)和对照组B(20例)。在治疗充血性心力衰竭基础上治疗组予以培哚普利10mg每日1次加比索洛尔5～10mg每日1次,对照组予以卡托普利25mg每日3次,倍他乐克25～50mg每日2次,定期门诊随访、复查心脏彩超、心脏三位片、心电图并综合评价其疗效、预后情况及临床心功能改善状况。结果治疗组A患者,心室率控制良好、心功能明显改善、劳动强度和生活质量提高,复查心电图及心脏彩超、心室率控制在60～100/min,左室舒张末期内径较治疗前缩小、左室收缩未内径较治疗前缩小,心肌收缩力增强,左室射血分数增高,再住院率及病死率(5年)明显下降,生活质量提高。结论长期口服培垛普利、比索洛尔治疗扩张型心肌病可明显改善心功能不全临床症状。降低再住院率、病死率,提高生活质量,改观预后。因此培垛普利、比索洛尔可作为扩张型心肌病、充血性心力衰竭患者常规有效治疗。
Objective To observe the curative effect of perindopril and bisoprolol in the treatment of dilated cardiomyopathy and congestive heart failure and to evaluate its prognosis. Methods Fifty-eight patients with already diagnosed dilated cardiomyopathy complicated with heart failure were divided into treatment group A (38 cases) and control group B (20 cases) according to patients’ wishes and economic conditions. On the basis of the treatment of congestive heart failure, the treatment group was treated with perindopril 10mg once daily plus bisoprolol 5 ~ 10mg once daily, while the control group was given captopril 25mg three times daily and metoprolol 25 ~ 50mg twice a day, regular out-patient follow-up, review of echocardiography, cardiac three tablets, ECG and comprehensive evaluation of its efficacy, prognosis and clinical cardiac function to improve the situation. Results In the treatment group A, the ventricular rate was well controlled, the cardiac function was significantly improved, the labor intensity and the quality of life were improved. The electrocardiogram and echocardiography were reviewed. The ventricular rate was controlled at 60-100 min, and the diameter of the left ventricular end-diastolic diameter was reduced. Ventricular contractions did not shrink more than before treatment, myocardial contractility increased, left ventricular ejection fraction increased, rehospitalization and mortality (5 years) decreased significantly, quality of life improved. Conclusion Long-term oral administration of benazepril and bisoprolol in the treatment of dilated cardiomyopathy can significantly improve the clinical symptoms of cardiac insufficiency. Reduce the rate of rehospitalization, mortality, improve quality of life, change the prognosis. Therefore, Pei Du Pou, bisoprolol can be used as dilated cardiomyopathy, conventional treatment of patients with congestive heart failure.