卡维地洛对充血性心力衰竭神经激素及心功能的影响

THE EFFECTS OF CARVEDILOL ON NEUROHOMONE AND HEART FUNCTION IN CONGESTIVE HEART FAILURE

为了解卡维地洛对充血性心力衰竭患者神经激素及心功能的影响 ,将 35例充血性心力衰竭病人双盲随机分为卡维地洛组、安慰剂组 ,两组病人基础临床特征相似。于治疗前、后检测血浆中去甲肾上腺素 (NE)、血管紧张素Ⅱ (AngⅡ )浓度、血浆肾素活性 (PRA) ,左心室射血分数 (LVEF)及左心室腔径变化 ,15例健康人为正常对照组。结果显示 :心衰患者血浆中NE、AngⅡ、PRA均较正常对照组升高 (P <0 .0 1) ,卡维地洛组与安慰剂组相比血浆NE、PRA、AngⅡ水平下降 (P <0 .0 1) ,LVEF升高 (P <0 .0 1) ,左室舒张末径 (LVDd)、左室收缩末径(LVDs)均缩短 (P <0 .0 1)、左室收缩末容量 (ESV)减小 (P <0 .0 1)。提示卡维地洛能阻断神经激素对充血性心力衰竭的不良影响 ,改善患者左心功能 ,长期使用可使扩大的左心室腔径缩小。

To investigate the effects of Carvedilol on neurohormone and heart function in patients with congestive heart failure(CHF) by double blinded, randomized clinical trial. 35 congestive heart failure patients were double blinded and randomly divided into 2 groups, Carvedilol group and placebo group. 15 healthy persons constitute the normal control group. We measured the plasma concentration of norepinephrine(NE), angiotensin (Ang) and plasma renin activity (PRA) , meanwhile left ventricular ejection fraction (LVEF) , left ventricular dimension and volume were observed before and after treatment. The plasma concentrations of NE, Ang Ⅱ and PRA were found to be higher in patients with CHF than those of healthy control group ( P <0.01 ). All these parameters were significantly reduced ( P <0.01), and the patient′s LVEF improved( P <0.01), and also left ventricular diastolic dimension (LVDd), left ventricular systolic dimension (LVDs),and end systolic volume (ESV) decreased( P <0.01) in Carvedilol group compared with those in placebo group at the end of the treatment. It indicated that Carvedilol could significantly reduce the plasma concentration of neurohormones in patients with CHF, and meanwhile improve the patient's left ventricular function , reduce left ventricular dimension and volume.