比索洛尔联合曲美他嗪治疗左心室射血分数保留的心力衰竭的临床研究  

Clinical trial of bisoprolol combined with trimetazidine in the treatment of heart failure with preserved left ventricular ejection fraction

作　　者：甄宇治[1] 

机构地区：[1]河北医科大学第一医院心血管内科,石家庄050031

出　　处：《中国临床药理学杂志》2016年第19期1735-1737,1741,共4页The Chinese Journal of Clinical Pharmacology

基　　金：河北省卫生计划科技基金资助项目(20130278)

摘　　要：目的观察比索洛尔联合曲美他嗪治疗左心室射血分数保留的心力衰竭(HFPEF)的临床疗效及安全性。方法将80例HFREF患者随机分为对照组40例和试验组40例。对照组予以口服曲美他嗪20 mg,tid;试验组在对照组治疗的基础上,予以口服比索洛尔,qd,起始剂量2.5 mg,最大剂量不超过10mg·d^(-1)。2组患者均治疗1个月。比较2组患者的临床疗效、心脏舒张功能、神经内分泌因子指标和药物不良反应的发生情况。结果治疗后,试验组和对照组的总有效率分别为90.00%(36/40例)和70.00%(28/40例),差异有统计学意义(P<0.05)。治疗后,试验组和对照组的舒张晚期血流峰速率分别为(61.87±5.72),(67.03±6.11)ms·s^(-1);早期血流峰速率分别为(55.94±7.52),(51.42±4.97)ms·s^(-1);舒张晚期血流峰速率/早期血流峰速率分别为(0.88±0.35),(0.78±0.34)ms·s^(-1);B型尿钠肽分别为(227.94±25.83),(274.85±26.59)pg·m L^(-1);血清氨基末端脑钠肽前体分别为(1.85±0.57),(2.68±0.62)ng·L^(-1);内皮素分别为(71.59±17.97),(84.35±22.16)pg·m L^(-1);高敏C反应蛋白分别为(5.02±1.23),(6.92±1.46)mg·L^(-1),差异均有统计学意义(P<0.05)。试验组出现1例心动过缓,对照组未见不良反应发生,试验组与对照组的药物不良反应发生率比较差异无统计学意义(2.50%vs 0,P>0.05)。结论比索洛尔联合曲美他嗪治疗左心室射血分数保留的心力衰竭的临床疗效显著优于单用曲美他嗪,前者可显著改善患者的心脏舒张功能,降低神经内分泌因子水平,且不增加药物不良反应的发生率。Objective To observe the clinical efficacy and safety of bisoprolol combined with trimetazidine in the treatment of heart failure with left ventricular ejection fraction（HFPEF）.Methods Eighty patients with HFREF were randomly divided into control group（n = 40） and treatment group（n = 40）.Control group was given oral trimetazidine 20 mg,tid.Treatment group on the basis of the control group was given oral bisoprolol,qd,starting dose of 2.5 mg,maximum dose does not exceed10 mg·d^（-1）.2 groups of patients were treated for 1 months.The clinical efficacy,cardiac diastolic function,neuroendocrine factor index and adverse drug reactions were compared between two groups.Results After treatment,the total effective rates of treatment and control groups were90.00%（36/40） and 70.00%（28/40） with significant difference（P 〈0.05）.After treatment,among the main indexes in the treatment and control groups,the iastolic late peak flow rates were（61.87 ± 5.72）,（67.03 ± 6.11） ms·s^（-1）;the early peak flow rates were（55.94 ± 7.52）,（51.42 ±4.97） ms·s^（-1）;the ratio iastolic late peak flow rate/early peak flow rate were（0.88 ± 0.35）,（0.78 ± 0.34）;B type natriuretic peptide were（227.94 ± 25.83）,（274.85 ± 26.59） pg·m L^（-1）;serum N-terminal brain natriuretic peptide precursor were（1.85 ± 0.57）,（2.68 ± 0.62） ng · L^（-1）;endothelin respectively were（71.59 ± 17.97）,（84.35 ± 22.16） pg·m L^（-1）;high-sensitivity C-reactive protein were（5.02 ± 1.23）,（6.92 ± 1.46） mg·L^（-1）,with significant difference（P 〈0.05）.There were 1 case of bradycardia in treatment group,and control group had no adverse drug reactions.The incidence of adverse drug reactions in treatment and control groups had no statistically significant difference（2.50% vs 0,P 〉0.05）.Conclusion Bisoprolol combined with trimetazidine has a definitive clinical efficacy for the treatment of HFPEF,which is better than single use of trimetazidine,also it

关 键 词：比索洛尔 曲美他嗪 左心室射血分数保留 心力衰竭 安全性 

分 类 号：R972[医药卫生—药品]