卡维地洛在治疗顽固性心力衰竭的疗效观察

Clinical effect of carvedilol on patients with refractory heart failure

目的：评价第三代β受体阻滞剂卡维地洛治疗顽固性心力衰竭的临床疗效。方法：26例顽固性心力衰竭患者随机分为卡维地洛组和对照组。卡维地洛从1．56～3．125mg开始使用，1次／d，如能耐受，渐递增到6．25～12．5mg，2次／d，长期维持。检测治疗前后顽固性心力衰竭患者心功能和超声心动图的变化。结果：治疗3个月后，治疗组心脏功能分级较对照组明显改善（P〈0.05）；超声心动图检查示卡维地洛治疗前后左心室射血分数（LVEF，％）、短轴缩短率（FS，％））明显增加（P〈0．01），毒心室收缩末期内径（LVESd，mm）、左心舒张末期内径（LVEDd，mm）明显减小（P〈0．01）。和对照组比较，治疗后LVEF（％）、FS（％）差异有统计学意义（P〈0.05）；两组治疗后LVESd、LVEDd差异有统计学意义（P〈0.05）。结论：在病情相对稳定的适当时机，从小剂量开始服用卡维地洛，并逐渐增加剂量，长期坚持能够改善顽固性心力衰竭患者左室。心功能，逆转左心室重构。

Objective To evaluate the clinical effect of carvedilol in the treatment of refractory heart failure. Methods Twenty-slx patients with refractory heart failure were randomly divided into 2 groups. Carvedilol group was given from 1.56 mg once a day,to 12.5 mg twice a day if patients could tolerate. Cardiac function and echocardiography were viewed before and after treatment for 3 months. Results The effect of cardiac function was greatly improved compared to control group（P〈0.05）. After treatment, left ventricular eject fraction and fraction shorting were increased （P〈0. 01）, and left ventricular end-diastolic diameter and left ventricular end-systolic diameter measured by echocardiography were reduced（P〈0. 01,respectively）. There was a significant difference between carvedilol group and control after treatment. There was a significant difference in left ventricular endsystolic diameter and left ventricular end-diastolic diameter between two groups （P 〈 0. 05 ）. Conclusion Carvedilol is increased gradually from a little close to objective ones . It could improve the cardiac function and prevent left ventricular remolding in the patients with refractory heart failure.