小剂量β-受体阻滞剂治疗严重心力衰竭  

LOW-DOSE β-BLOCKADE IN THE TREATMENT OF SEVERE HEART FAILURE

作　　者：官淑霞[1] 吴长江[1] 万志强[1] 

机构地区：[1]蚌埠医学院附院心内科

出　　处：《蚌埠医学院学报》1992年第4期251-253,共3页Journal of Bengbu Medical College

摘　　要：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 61 patients with chronic severe heart failure conventional used standard therapy was inef- fective, added low-dose β-blockade with prooranolol was found in association with improved ventricular performance. Among them,the significant inprovement accounted for 23 cases(37. 74%), general improvement for 34 cases (55. 73%) and deterioration in cardiac function for 4 cases (6. 55%). Before and after taking drugs,the change of blood pressure was not striking. After taking propranolol, resting heart rate and that after exercise were markedly decreased. The macha-nisms are discussed as follows:(l)The secretion of catecholamines is increased ing heart failure, β-blocking drugs could prevent cardiotoxic effects of catecholamines. (2)Down-regulated β-adren-ergic-receptor density could restore. (3)Myocardial contractility is significantly improved but does not expense myocardial oxygen consumption. (4)Improved myocardial relaxation and decreased myocardial oxygen consumption. (5)Improved myocardial diastolic performance. (6)Dilated vas-cula and decreased the cardiac volume and pressure load.

关 键 词：心力衰竭 Β受体阻断剂 心得安 

分 类 号：R541.605[医药卫生—心血管疾病]