卡维地洛治疗扩张型心肌病心力衰竭的疗效观察

Observation of the effect of carvedilol in congestive heart failure in patients with dilated cardiomyopathy

目的:探讨卡维地洛对扩张型心肌病(DCM)心力衰竭(CHF)的临床疗效。方法:60例DCM并CHF患者在利尿剂、洋地黄、ACEI及硝酸盐制剂治疗的基础上,随机分为卡维地洛治疗组及常规治疗组(每组30例)。治疗前及4个月用超声心动图测左室缩短分数(FS),射血分数(EF)、左室舒张末内径(LVDD)、室间隔厚度(IVS)和左室后壁厚度(LVPW)。结果:治疗4月后,两组心功能改善。卡维地洛LVDD[(60.5±6.6)与(67.3±6.1)mm,P<0.05]、EF[(47.8±9.7)与(40.5±6.4)%,P<0.05]、D/T[(4±0.7)与(4.5±0.5),P<0.05]显著改善。结论:卡维地洛能显著改善DCM心功能及心肌重构。

Objective：To investigate the clinical effect of carvedilol in the treatment of congestive heart failure （CHF） in patients with dilated cardiomyopathy（DCM）. Methods：60 DCM patients with CHF were randomly divided into carvedilol group and control group on the basis of digitalis,diuretic,ACEI and nitro-glycerine treatment,with 30 cases in each group. The fraction shortening（FS）,left ejection fraction（EF）,strok volume（SV）,left ventricular diastolic dimension（LVDD）,interventricular septum（IVS） and left ventricular posterior wall （LVPW） in both groups were measured with echocardiography before and 4 months after treatment. Results：4 months after treatment ,the cardiac funtion in both groups improved markedly, but that in carvedilol group improved more significantly compared with that in control group,such as LVDD（60.5±6.6 vs 67.3±6.1,〈0.05）,EF（47.8±9.7 vs 40.5±6.4,P〈0.05）,and D/T（4±0.7 vs 4.5±0.5,P〈 0.05）. Conclusion：Carvedilol possesses protective effect on cardiac function and myocardium in DCM patients with CHF.