卡维地洛与美托洛尔治疗慢性心力衰竭的长期疗效观察

Long-Term Observation on Clinical Effeetive Comparison between Carvediol and Metoprolol in Treating Chronic Heart Failure

目的对比第三代β受体阻滞剂卡维地洛(carvediol)与第二代β受体阻滞剂美托洛尔(metoprolol)对慢性充血性心力衰竭(CHF)的长期临床疗效,为临床治疗的药物选择提供依据。方法81例患者随机分为卡维地洛组(n=43)和美托洛尔组(n=38),治疗6个月,监测治疗前后心率(HR)、血压(BP)、左心室内径(LVEDD、LVESD)、射血分数(LVEF)的变化。结果美托洛尔组心率的减慢明显优于卡维地洛组(P<0.01),卡维地洛组收缩压和舒张压的下降比美托洛尔组明显(P<0.05),卡维地洛组LVEF、LVEDD与LVESD的改善优于美托洛尔组(P<0.05)。结论美托洛尔有更明显的减慢性率的作用,卡维地洛有更好的降压、增加心肌收缩力,改善心功能作用,还表现出更强的逆转心肌重构作用。

Objective:To compare the long-term clinical effect of the two kinds of β-blockers on chronic heart failure so as to provide refeences for clinical drug selection.Methods:81 patients were randomly divided into two groups:carvediol group(n=43) and metoprolol group(n=38),and then the changes of heart rate,blood pressure,LVEDD,LVESD,LVEF,6MWT distance were observed during the treatment for 6 months.Results:The reduction of HR in metoprolol group was more obvious than that in carvediol group(P<0.01);the decline of SBP and DBF,and the improvement of LVEF,LVEDD and LVESD in carvediol group were more significant than those in metoprolol group(P<0.05).Conclusions:Metoprolol was more effective improving contractive power of cardiac muscle and cardiac function;in addition,carvediol presented more evident effect in remodeling of cardiac muscle.