应用卡维地洛、比索洛尔和常规方法治疗慢性心力衰竭临床疗效比较

Comparison of Clinical Efficacies in Carvedilol,Bisoprolol and Conventional Therapies for Patients with Chronic Heart Failure

目的比较应用卡维地洛、比索洛尔和常规方法治疗慢性心力衰竭(CHF)的疗效。方法92例CHF患者分为卡维地洛组(34例)、比索洛尔组(38例)和常规组(20例)。常规组应用血管紧张素转换酶抑制剂、利尿剂和洋地黄制剂,卡维地洛组和比索洛尔组在常规治疗基础上分别加用卡维地洛和比索洛尔。随访半年,分别测量治疗前后心率、血压6、min步行试验距离,并用超声心动图测定心功能进行疗效观察。结果1)卡维地洛组和比索洛尔组心率、血压和心肌耗氧量均较常规组明显降低,6min步行试验距离增加,但差异无统计学意义。2)卡维地洛组和比索洛尔组左心室舒张末径(LVEDD)和左心室收缩末径(LVESD)显著低于常规组,左心室射血分数(LVEF)显著高于常规组,且卡维地洛组LVESD较比索洛尔组明显减小。结论卡维地洛和比索洛尔通过β1受体阻滞等作用,逆转左心室重构,在改善CHF患者心功能方面作用相似。

Objective To compare the efficacies of earvedilol, bisoprolol and conventional therapies for patients with chronic heart failure （CHF）. Methods we assigned 92 patients with CHF to three groups, one was conventional therapies group （n=20） treated with ACE inhibitor＋digoxin＋diuretic, the other two groups were carvedilol group （n= 34） and bisoprolol group （n= 38） treated respectively with carvedilol or bisoprolol in addition to the above regular treatment. All the patients were followed up for six months and measured respectively the changes of heart rate, blood pressure, 6 minutes walking distance and cardiac function by echocardiography. Results 1） After treatment, the heart rate, blood pressure and myocardial oxygen consumption of the patients in the carvedilol group and bisoprolol group all decreased significantly compared with those of conventional group. In the meantime 6 minutes walking distance increased, but no significantly. 2） After treatment, LVEDD and LVESD were smaller in the carvedilol group and bisoprolol group than those in conventional group, and LVEF was higher than that in conventional group. LVESD was smaller in the carvedilol group than that in the bisoprolol group. Conclusion Carvedilol and bisoprolol can further reverse the remodelling of left ventricle and improve cardiac function through their β1 receptors blocking function. The clinical efficacies of Carvedilol and bisoprolol were similar.