卡维地洛治疗慢性心力衰竭疗效预测参数研究

Study on predictive efficacy of carveidilol in treating chronic heart failure

目的运用常用的临床指标预测卡维地洛(Carvedilol)治疗慢性心力衰竭(CHF)的效果.方法44例心衰患者(NYHAⅡ～Ⅳ)随机分为常规治疗组和卡维地洛组,并且根据治疗效果再将卡维地洛组分为疗效显著亚组(A组)和疗效不显著亚组(B组),通过临床监测探讨卡维地洛疗效显著的预测参数.结果(1)卡维地洛治疗可以明显改善患者心功能、抑制心肌重构;(2)A组患者(n=13)收缩压明显高于B组(n=7)(P＜0.05);(3)A组血清Na+浓度高于B组、血清K+低于B组(P＜0.05).结论从卡维地洛治疗心衰疗效显著的患者分析中,提示治疗前的收缩压水平、血清Na+和血清K+浓度可以预测CHF的疗效.

Objective To evaluate the predictive parameters for judging the therapeutic efficacy of carvedilol in the treatment of chronic heart failure（CHF）. Methods Fourty-four patients with CHF（grade Ⅱ - Ⅳ, heart function classification of New York Heart Association） were divided into conventional treatment group and carvedilol group randomly. According to the curative effect, carvedilol group was divided into two subgroups,hight efficacy group（subgroup A） and less efficacy group（subgroup B）. The systolic blood pressure（SBP）,serum Na^＋ and K^＋ were detected before and after the treatment and the results were analyzed statistically. Results The heart function was improved markedly and the myocardial reconstruction was inhibited obviously with carvedilol. SBP in subgroup A was higher than that in subgroup B（P〈0.05）. Serum Na^＋ in subgroup A was higher than that in subgroup B,while serum K^＋ in subgroup A was lower than that in subgroup B（P〈0.05）. Conclusion The levels of SBP,serum Na^＋ and K^＋ before the treatment may be as predictive parameters for evaluating the therapeutic efficacy of CHF with carvedilol.