卡维地洛治疗充血性心力衰竭72例临床分析

A Clinical Analysis of Treatment of Congestive Heart Failure with Carvedilol

目的:观察卡维地洛治疗充血性心力衰竭(CHF)的疗效和安全性。方法:选择CHF患者72例,随机分为心衰常规治疗组(35例)和卡维地洛治疗组(37例),后者在常规抗心衰治疗基础上加用卡维地洛,从小剂量开始,渐增至最大耐受量,疗程6个月,两组治疗前和治疗3、6个月均使用超声心动图分别测定左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)和左心室射血分数(LVEF),并观察6min步行距离,心率变化,记录不良反应。结果:CHF患者用卡维地洛治疗后,LVEDD、LVESD和LVEF的改善均优于常规治疗组(P<0.01),6min步行距离增加较常规治疗组更为显著(P<0.01)、心率有所下降,但在治疗6个月后,心率稳定,治疗期间无严重不良反应出现。结论:在心衰常规治疗基础上加用卡维地洛治疗CHF,可明显改善心功能,提高运动耐量,缩小心室,改善左室重构。

Objective. To evaluate the safety and clinical efficacy of carvedilol in the treatment of congestive heart failure（CHF） in elder patients. Methods. Seventy two patients with CHF were divided randomly into CHF treatment group（group Ⅰ,n=35） and carvedilol treatment group（group Ⅱ, n=37）. The conventional therapy was given in group Ⅰ. In group Ⅱ, carvedilol ＋ the conventional therapy same as in group Ⅰ was performed from a low dose to a maximal tolerance dose for 6 months. Left ventricular end - diastolic diameter（LVEDD）, Left ventricular end - systolic diameter（LVESD）, Left ventricular eject fraction（LVEF） and 6 minute walk distance were measured before and after 3, 6 months treatment respectively. Results： After treatment, LVEDD and LVESD in group Ⅱ were significantly decreased compared with those in group [ （P〈0. 01）. The increase oF LVEF and 6-minute walk distance in group Ⅱ was greater than that in group Ⅰ（P〈0. 01）. There were no severe side effects find in group Ⅱ. Conclusions： On the basis of conventional therapy of CHF, addition of even smaller dose of carvedilol could ameliorate cardiac function, reduce cardiac fchamber and improve myocardium remodeling, and increase exercise capability in the patients with CHF.