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本文报道加用小剂量心得安治疗慢性严重心力衰竭61例取得明显疗效,其中显效23例(37.74％),有效34例(55.73％),无效4例(6.55％)。服药前后血压无明显变化;服药后静息时心率及活动后心率有明显减慢。其机制可能:(1)由于心衰时儿茶酚胺分泌增多,β-受体阻滞剂保护衰竭的心肌免受过多的儿茶酚胺毒害。(2)使心衰时下调的β-受体密度上调。(3)改善心肌收缩力而不增加心肌耗氧量。(4)使心肌松弛降低心肌耗氧量。(5)改善心肌的舒张功能。(6)扩张血管降低心脏前后负荷。
In this paper, with a small dose of propranolol treatment of chronic heart failure in 61 cases achieved significant effect, of which 23 cases were markedly effective (37.74%), effective in 34 cases (55.73%), ineffective in 4 cases (6.55%). No significant changes in blood pressure before and after taking medication; resting heart rate and heart rate after exercise significantly slowed down. The mechanism may be: (1) β-blockers protect failing myocardium from excessive catecholamine toxicity due to increased catecholamine secretion during heart failure. (2) The β-receptor density is down-regulated during heart failure. (3) improve myocardial contractility without increasing myocardial oxygen consumption. (4) make myocardial relaxation reduce myocardial oxygen consumption. (5) improve myocardial diastolic function. (6) dilate blood vessels reduce the heart before and after the load.