卡维地洛对心力衰竭病人血流动力学相关指标影响

EFFECT OF CARVEDILOL ON HEMODYNAMICS OF PATIENTS WITH CHRONIC HEART FAILURE

①目的 观察卡维地洛对心力衰竭 (心衰 )病人血流动力学状态及心室功能的影响。②方法 选择NYHA分级Ⅱ～Ⅲ级的慢性心力衰竭病人 77例 ,随机分成两组 ,治疗组 4 9例 ,给予卡维地洛治疗 ,剂量由 6 .2 5mg增至 2 5 .0 0mg ,每日 2次 ,持续 8周 ;对照组 2 8例 ,给予常规治疗。两组均应用无创血流动力学检测仪监测治疗开始及终点的血流动力学指标 ,同时作超声心动图检查 ,以评价左室功能。③结果 治疗后对照组病人左心做功指数 (LCWI)、左室排血分数 (LVEF)增高 ,心率 (HR)、体循环阻力指数 (SVRI)、左室舒张末内径降低 ,差异有显著意义 (t=1 .6 5～ 1 .86 ,P <0 .0 5 ) ;治疗组LCWI、LVEF显著增高 ,HR、SVRI、左室舒张末内径显著降低 ,差异有显著意义 (t=2 .0 3～ 2 .38,P <0 .0 5 ) ;以上各指标两组间比较差异亦有显著性 (t=1 .72～ 1 .98,P <0 .0 5 )。④结论 卡维地洛可以降低心脏前、后负荷 。

Objective To evaluate the effect of carvedilol on hemodynamics and left ventricular function of patients with chronic heart failure(CHF). Methods Seventy seven CHF patients at NYHA Ⅱ-Ⅲ degrees were randomised to carvedilol and control groups. Forty nine patients in the carvedilol group were treated with gradually increasing dose of carvedilol from 6.25 mg to 25.00 mg, b.i.d. for eight weeks. Twenty eight control patients were treated with conventional medicine. BioZ.com and echocardiography were used to examine all the patients, at the beginning and at the end of the treatment, to assess hemodynamics and left ventricular function. Results For the controls, left cardiac work index(LCWI), left ventricular ejection fraction(LVEF) increased; while heart rate, systemic vascular resistance index(SVRI), left ventricular(LV) end diastolic size decreased ( t=1.65-1.86,P <0.05). For the patients in the carvedilol group, LCWI, LVEF increased and HR, SVRI, LV end diastolic size decreased more significantly in carvedilol group ( t=2.03-2.38,P <0.05). There was significantly difference between the two groups (t=1.72-1.98,P <0.05). Conclusion Carvedilol can reduce cardiac load and improve left ventricular function.