小剂量卡维地洛治疗重度充血性心力衰竭短期临床观察

LOW-DOSE CARVEDILOL IN SEVERE CONGESTIVE HEART FAILURE

目的 观察小剂量卡维地洛治疗重度充血性心力衰竭 (CHF)的临床耐受性和安全性。方法 2 8例重度CHF患者在标准治疗基础上 (利尿剂、血管紧张素转换酶抑制剂 (ACEI)和洋地黄类制剂等 )加用卡维地洛 ,起始剂量 3.12 5mg ,2 /d ,2周后增至 6 .2 5mg ,2 /d ,维持 3个月 ,治疗前后分别对患者心功能 (NYHA分级法 )、血压、心率、及生化指标进行检测 ,以评价小剂量卡维地洛治疗重度CHF的耐受性、安全性及疗效。结果 应用小剂量卡维地洛治疗 3个月后患者心功能较治疗前改善 ,12例心功能由Ⅲ、Ⅳ级改善为Ⅱ级 ,心率、左心室舒张末期压下降 ,不良反应少 ,对肝肾功能、血糖、血脂、血常规均无影响 ,耐受性好。结论 小剂量卡维地洛治疗重症CHF短期疗效。

Objective To observe tolerance and safety of low-dose carvedilol in patients with severe congestive heart failure. Methods Carvedilol was added on basic standard therapy in 28 patients beginning with dosage of 3.125mg bid,and which,two weeks later,increased to 6.25mg bid till 3 months after.Before and after treatment with carvedilol,NYHA class,signs including blood pressure and heart rate,laboratory test were performed. Results After treatment with low-dose carvedilol,NYHA class was improved,12 patients improved from class Ⅲ、Ⅳ to class Ⅱ(efficiency was 42.8%),none became worsen,adverse events were seldom observed,blood routine,liver,renal function weren't changed,all patients can tolerate low-dose carvedilol. Conclusion Low-dose carvedilol is effective and safe in the treatment of severe CHF patients with good tolerance.