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目的比较比索洛尔在不同心律状态下的慢性充血性心力衰竭(CHF)患者治疗剂量耐受情况。方法对142例CHF患者[其中窦性心律(窦律)102例,心房颤动(房颤)心律28例,起博器心律12例]在常规心力衰竭(心衰)治疗基础上口服比索洛尔,逐渐加量至目标剂量。治疗目标分别为①心室率下降到50~65次/min(不低于50次/min);②稍加剂量心功能下降1级;③收缩压不低于90mmHg(1mmHg=0.133kpa);④达最大剂量10mg/d。结果窦律者比索洛尔平均剂量低于房颤和起博器心律者[(4.25±0.75)mg/d(7.14±1.20)mg/d和(7.23±1.22)mg/d,P<0.01];窦律者达心率目标的平均剂量低于达心衰的目标剂量,房颤者心率和心衰的目标剂量相当,而3种不同心律患者达心衰目标剂量无明显差异(P>0.05)。结论不同心律的CHF患者对比索洛尔的耐受性均较好,且房颤和起博器心律者好于窦律患者。
Objective To compare the therapeutic dose-response of bisoprolol in patients with chronic congestive heart failure (CHF) under different heart rhythms. Methods One hundred and twenty-two CHF patients, including 102 cases of sinus rhythm (sinus rhythm), 28 cases of cardiac fibrillation (atrial fibrillation) and 12 cases of pacemaker heart rhythm, were given bisoprolol on the basis of conventional heart failure , Gradually increase the dose to the target. Treatment goals were ① ventricular rate decreased to 50 to 65 beats / min (not less than 50 beats / min); ② a slight increase in cardiac function decreased by 1; ③ systolic blood pressure not less than 90mmHg (1mmHg = 0.133kpa); ④ The maximum dose of 10mg / d. Results The mean dose of bisoprolol in sinus rhythm was lower than those in atrial fibrillation and pacemaker ([4.25 ± 0.75] mg / d (7.14 ± 1.20) mg / d and (7.23 ± 1.22) mg / d, P <0.01] ; The mean dose of sinus rhythm reached the goal of heart rate lower than the target dose of heart failure, atrial fibrillation, heart rate and heart failure target dose equivalent, and 3 different heart rate patients with heart failure target dose was no significant difference (P> 0.05) . CONCLUSIONS: Patients with different rhythm of heart rate were more tolerant of bisoprolol, and those with atrial fibrillation and pacemaker were better than patients with sinus rhythm.