卡维地洛对心力衰竭患者心脏结构及功能的疗效观察

Effect of carvedilol on heart structure and function of heart failure patients

目的观察卡维地洛对心力衰竭患者心脏结构及功能的影响。方法选择心功能Ⅱ～Ⅳ级的患者40例,入院后每日观察心率及血压,将患者分为常规治疗组(T组,20例)和卡维地洛组(CA组,20例),院外随访治疗6个月,于治疗前后分别做超声心动图进行比较。结果T组治疗后较治疗前左室射血分数(LVEF%)、短轴缩短分数(FS%)、舒张期二尖瓣血流频谱E波峰值流速与A波峰值流速之比(E/A)明显提高(P<0.05),左室舒张末内径[LVED(dmm)]、左室收缩末内径[LVES(dmm)]及等容舒张时间(IRT)明显缩小及缩短(P<0.05);CA组治疗后较治疗前LVEF、FS、E/A显著增加(P<0.05,LVEDd、LVESd及IRT明显缩小及缩短(P<0.05;CA组与T组疗效比较:CA组△LVEF、△FS、△E/A显著大于T组(,P<0.05),△LVEDd、△LVESd、△IRT显著大于T组(P<0.05)。结论ACEI类药物可抑制心衰患者的心脏重构,改善心功能,卡维地洛与ACEI类药物和用对改善心脏的结构及功能则显著优于单用ACEI类药。

[Objective] To investigate the effect of carvedilol on heart structure and function of heart failure patients. [Method] 40 patients of cardiac function Ⅱ-Ⅳ were chosen, and the Heart Rate （HR） and Blood Pressure （BP） were recorded every day. Patients were divided into 2 groups： normal treatment group （T group, n=20） and Carvedilol group （CA group, n=20）. The echocardiography taken before and after the flow up treatment outside hospital for 6 months was compared. [Restdt] T group： Left ventricular ejection fraction （LVEF）, Fraction shortening （FS） and E/A value of mitral flow （E/A） was higher after treatment （P 〈0.05）. Left ventricular end diastolic dimension （LVEDd）, Left ventricular end sysstolic dimension （LVEsd） and Isovolumic relaxation time（IRT） was shortened after treatment （P 〈0.05）. CA group： LVEF, FS, E/A was higher after treatment （P 〈0.05）. LVEDd, LVEsd, IRT were shortened after treatment （P 〈0.05）. Comparison of T group and CA group： ΔLVEF,ΔFS, ΔE/A of CA group was higher than that of T group （P 〈0.05）. ΔLVEDd, ΔLVEsd, ΔIRT of T group was higher than that of CA group （P 〈 0.05）. [Conclusion] Angiotensin converting enzyme inhibition （ACEI） can inhibit the heart remodeling and improve the cardiac function. Carvedilol combination with ACEI is better than ACEI indeviduely on improving the heart structure and function of Heart failure patients.