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不同剂量比索洛尔对老年高血压病并发舒张性心力衰竭左室舒张功能的影响

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2011年第2期
页码:
227-230
栏目:
临床研究
出版日期:
2010-12-10

文章信息/Info

Title:
Effect of different dosages of bisoprolol on diastolic function of elderly hypertensive patients with diastolic heart failure
作者:
王文艳1; 谢蒂立1; 周晓芳1; 钟萍1; 李春梅2; 金静1; 汤夏莲1
四川省医学科学院、四川省人民医院：1.干部科；2.心脏超声科，四川 成都 610072
Author(s):
WANG Wen-yan1;  XIE Di-li1;  ZHOU Xiao-fang1;  ZHONG Ping1;  LI Chun-mei2;  JIN Jing1;  TANG Xia-lian1
1.Department of Cadre Healthcare, 2.Department of Echocardiography, Sichuan Academy of Medical Science & Sichuan Provincial People’s Hospital, Chengdu 610072, Sichuan, China
关键词:
高血压; 原发性;  舒张功能不全; 超声心动图; 比索洛尔; 老年人
Keywords:
hypertension;  diastolic dysfunction;  echocardiography;  bisoprolol;  aged
分类号:
R972
DOI:
-
文献标识码:
A
摘要:
目的: 观察不同剂量的比索洛尔对舒张性心力衰竭患者左室舒张功能的影响。方法: 92例高血压病并发左室舒张功能不全但左室射血分数（LVEF）>50%的患者，在氨氯地平控制血压达标（<140/90 mmHg）的基础上，按照加用比索洛尔的剂量随机分为3组：对照组（不用比索洛尔组，n=31），低剂量组（加用比索洛尔1.25 mg，1次/d，n=30），高剂量组（加用比索洛尔5 mg，1次/d，n=31），平均随访观察30周。采用超声多普勒心动图评估治疗前后左室结构和功能参数的变化。结果: 3组治疗后LVEF和收缩压无明显改变，舒张压和心率在低剂量组和高剂量组下降明显（P<0.05）。加用比索洛尔治疗后，患者E峰、A峰、E/A、E峰流速积分（VTIE）、A峰流速积分（VTIA）、流速时间积分比率(E-VTI/A-VTI）有不同程度改善，高剂量组较低剂量组改善更加显著（P<0.05）。左室舒张末内径（LVEDD）、室间隔厚度（IVSD）、左室后壁厚度（PWT）、左室质量指数（LVMI)在高剂量组变化显著(P<0.05)，对照组无显著改善。结论: 在氨氯地平降压达标基础上，比索洛尔能够进一步改善高血压病患者左室舒张功能，较大剂量作用更加显著。
Abstract:
AIM: To investigate the effect of different dosages of bisoprolol on the diastolic function of elderly hypertensive patients with diastolic heart failure. METHODS: Ninety-two hypertensive subjects with diastolic heart failure and left ventricular ejection fraction (LVEF) >50% according to the treatment of amlodipine were randomly divided into three groups: control (no bisoprolol given), low-dose group (bisoprolol 1.25 mg qd) and high-dose group (5 mg qd of bisoprolol). Left ventricular end-systolic diameter (LVED), interventricular septal diameter (IVSD), posterior wall thickness (PWT), LVEF, mitral valve E wave, A wave and E/A ratio, E wave velocity time integral (VTIE), A wave velocity time integral (VTIA) and VTIE/VTIA were assessed by echocardiography at baseline and 30 weeks after. RESULTS: No significant changes were seen in LVEF and systolic blood pressure after treatment compared with those at baseline. Diastolic blood pressure and heart rate decreased significantly in the low-dose group ［(86±4) vs.(75±9) mmHg, (75±9) vs.(71±6) l/min］ and high-dose group ［(87±4) vs.(76±10) mmHg, (71±8) vs.(68±12) l/min, P<0.05］ compared with those at baseline and those in the control group. Left ventricular diastolic function (E, A, E/A, VTIE, VTIA, E-VTI/A-VTI) in low-dose group and the high-dose group improved significantly, but the changes in the high-dose group were more obvious than those in the low-dose group (P<0.05). LVED (53.9±3.7 vs. 48.6±2.9), IVSD (11.2±1.5 vs. 7.8±0.7), PWT (9.2±2.8 vs. 8.2±2.8) and LVMI (121±48 vs. 97±20) decreased significantly in the high-dose group (P<0.05), whereas no obvious changes were seen in the contol group. CONCLUSION: Based on the treatment of amlodipine, bisoprolol improves the diastolic function of hypertensive patients with diastolic heart failure but with well-controlled blood pressure. Higher doses have a more obvious effect.

参考文献/References

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备注/Memo

备注/Memo:
收稿日期：2010-01-20.通讯作者：谢蒂立，住院医师，主要从事老年心血管疾病临床研究 Email：xenonsm@gmail.com 作者简介：王文艳，主治医师，博士Email：ddmm611@163.com
更新日期/Last Update: 2010-12-10